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C-reactive protein in relation to phenotypes of obstructive sleep apnea in paediatric patients


Authors: V. Kučeravá;  Júlia Kvaššayová;  D. Šutvajová;  L. Remeň;  P. Dvoran
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta, Univerzita Komenského a Univerzitná nemocnica, Martin, Slovensko
Published in: Čes-slov Pediat 2020; 75 (7): 416-420.
Category:

Overview

C-reactive protein (CRP) is a parameter indicating the presence of an inflammatory process in the body. In connection with obstructive sleep apnea, together with some pro-inflammatory cytokines, it is used in the prediction of possible organ complications – so far experimentally and in adult patients. The aim of this study was to determine the presence of the development of the inflammatory process at the subclinical level in a group of Slovak children with obstructive sleep apnea. Serum C-reactive protein levels were measured and compared in individual clinical phenotypes with a control group of healthy children, correlated with proportion of shallow sleep and a history of daily fatigue.

Methods: Polysomnografic (PSG) examinations were performed on a sample of 195 paediatric patients, of which 75 patients formed a control group without a diagnosed sleep-disordered breathing. Based on the measured anthropometric data, they were divided into groups with obesity and without obesity. We considered children to be obese whose Body Mass Index (BMI) was above the 95th percentile according to age and gender. Also, overweight children with a BMI percentile above 90 were included in this group. Normal weight was characterized by a BMI between the 5th and 90th percentiles. Children were also divided into groups according to individual clinical phenotypes of Obstructive Sleep Apnea (OSA). CRP was determined in a total of 172 children from venous blood collection.

Results and conclusion: In our patients, we found that CRP levels increase with the severity of OSA according to the Apnea/hypopnea index (AHI). We also found that CRP levels did not differ significantly between obese patients with OSA compared to obese patients without OSA. Patients complaining of higher levels of daily fatigue had higher CRP levels compared to patients without daily fatigue. In terms of OSA phenotypes, we found differences in the value of CRP – the highest showed children of phenotypes associated with obesity - the adult phenotype and the obese adenoid phenotype. No differences were found in the value of CRP to the proportion of shallow sleep.

Keywords:

CRP – inflammation – obstructive sleep apnea – paediatric age – phenotype


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Neonatology Paediatrics General practitioner for children and adolescents
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