title: Inflammatory Milieu and Cardiovascular Homeostasis in Children With Obstructive Sleep Apnea.
abstract: Biomarkers of atherosclerosis (pro-inflammatory cytokines and acute phase reactants) are elevated in children with obstructive sleep apnea (OSA). However, their association with cardiovascular endpoints in children are not understood. We hypothesized that biomarkers of atherosclerosis in children with OSA correlate with pulse transit time (PTT), a surrogate measure of vascular stiffness, with some positively influencing and others negatively influencing PTT.
  
  
  
  Children with OSA and matched controls were recruited to the study. Pro-inflammatory cytokines and acute phase reactants were measured at 6:00 pm and 6:00 am. Polysomnography with beat-to-beat blood pressure was performed. PTT during wakefulness and stage 2 sleep was calculated. Diurnal variation of biomarkers and their associations with PTT was estimated. Factor analysis was used to determine the effect of groups of cytokines on PTT.
  
  
  
  One hundred fifty-five children participated in the study; 90 were healthy controls and 65 had OSA. Children with OSA exhibited a different diurnal variation of biomarkers than healthy controls, with pro-inflammatory cytokines peaking in the morning and acute phase reactants peaking in the afternoon. Structural equation modeling demonstrated that interleukins 6 and 8, tumor necrosis factor-α, and sCD40L had a shortening effect, while serum amyloid A, C-reactive protein, and adiponectin had a prolonging effect on PTT. As a result, there was no difference in PTT between the two groups.
  
  
  
  The differential relationships of acute phase reactants and pro-inflammatory cytokines with PTT suggest that in children with OSA, these mediators may have opposing actions to maintain cardiovascular homeostasis.
authors.affiliation: Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: David F
authors.initials: DF
authors.lastname: Smith
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Md M
authors.initials: MM
authors.lastname: Hossain
authors.affiliation: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Arjan
authors.initials: A
authors.lastname: Hura
authors.affiliation: Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Guixia
authors.initials: G
authors.lastname: Huang
authors.affiliation: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Keith
authors.initials: K
authors.lastname: McConnell
authors.affiliation: Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Ishman
authors.affiliation: Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Raouf S
authors.initials: RS
authors.lastname: Amin
mesh_terms: D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D017286:Polysomnography; D063177:Pulse Wave Analysis; D000685:Serum Amyloid A Protein / Q000032:analysis; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014851:Wakefulness / Q000502:physiology
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D000685:Serum Amyloid A Protein; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Acute phase reactants; Inflammation.; Pediatric obstructive sleep apnea; Pulse transit time