title: Effects of adenotonsillectomy on plasma inflammatory biomarkers in obese children with obstructive sleep apnea: A community-based study.
abstract: BACKGROUND
  Obesity and obstructive sleep apnea syndrome (OSA) are highly prevalent and frequently overlapping conditions in children that lead to systemic inflammation, the latter being implicated in the various end-organ morbidities associated with these conditions.
  
  
  OBJECTIVE
  To examine the effects of adenotonsillectomy (T&A) on plasma levels of inflammatory markers in obese children with polysomnographically diagnosed OSA who were prospectively recruited from the community.
  
  
  METHODS
  Obese children prospectively diagnosed with OSA, underwent T&A and a second overnight polysomnogram (PSG) after surgery. Plasma fasting morning samples obtained after each of the two PSGs were assayed for multiple inflammatory and metabolic markers including interleukin (IL)-6, IL-18, plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), adiponectin, apelin C, leptin and osteocrin.
  
  
  RESULTS
  Out of 122 potential candidates, 100 obese children with OSA completed the study with only one-third exhibiting normalization of their PSG after T&A (that is, apnea-hypopnea index (AHI) ≤1/hour total sleep time). However, overall significant decreases in MCP-1, PAI-1, MMP-9, IL-18 and IL-6, and increases in adropin and osteocrin plasma concentrations occurred after T&A. Several of the T&A-responsive biomarkers exhibited excellent sensitivity and moderate specificity to predict residual OSA (that is, AHI⩾5/hTST).
  
  
  CONCLUSIONS
  A defined subset of systemic inflammatory and metabolic biomarkers is reversibly altered in the context of OSA among community-based obese children, further reinforcing the concept on the interactive pro-inflammatory effects of sleep disorders such as OSA and obesity contributing to downstream end-organ morbidities.
authors: Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors: L
authors: L
authors: Kheirandish-Gozal
authors: Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors: A
authors: A
authors: Gileles-Hillel
authors: 1] Sleep Unit, Burgos, Spain [2] CIBER of Respiratory Diseases. Instituto Carlos III.CIBERES, Burgos, Spain [3] Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors: M L
authors: ML
authors: Alonso-Álvarez
authors: Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors: E
authors: E
authors: Peris
authors: Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors: R
authors: R
authors: Bhattacharjee
authors: 1] Sleep Unit, Burgos, Spain [2] CIBER of Respiratory Diseases. Instituto Carlos III.CIBERES, Burgos, Spain [3] Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors: J
authors: J
authors: Terán-Santos
authors: 1] Sleep Unit, Burgos, Spain [2] CIBER of Respiratory Diseases. Instituto Carlos III.CIBERES, Burgos, Spain [3] Hospital Universitario de Araba, Vitoria, Spain.
authors: J
authors: J
authors: Duran-Cantolla
authors: Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors: D
authors: D
authors: Gozal
mesh_terms: D000233:Adenoidectomy; D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000503:physiopathology; D020382:Interleukin-18 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D009124:Muscle Proteins / Q000097:blood; D063766:Pediatric Obesity / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications / Q000601:surgery*; D014068:Tonsillectomy; D014157:Transcription Factors / Q000097:blood
chemical_list: D052242:Adiponectin; D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; C508600:IL6 protein, human; D020382:Interleukin-18; D015850:Interleukin-6; D020738:Leptin; D009124:Muscle Proteins; C480236:OSTN protein, human; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D014157:Transcription Factors; D020780:Matrix Metalloproteinase 9