C-reactive protein in children with obstructive sleep apnea and the effects of treatment

Abstract

Objective: To evaluate C-reactive protein (CRP) concentration in children with OSA and to determine the effects of treatment for OSA on its serum concentration. Methods: Consecutive children with habitual snoring and symptoms suggestive of OSA were recruited. They completed a sleep apnea symptom questionnaire, underwent physical examination and an overnight polysomnography (PSG). Fasting serum CRP and lipid profile were taken after overnight PSG. OSA was diagnosed if obstructive apnea index (OAI) > 1. Results: One hundred forty-one children with a median (IQR) age of 10.8 (8.5-12.8) years were recruited. There were 96 boys and the commonest presenting symptoms were nocturnal mouth breathing, prone sleeping position and poor attention at school. Forty-five children were found to have OSA and those with moderate disease (OAI > 5) had significantly higher CRP levels compared to their non-OSA counterparts [1.3 (0.8-3.6) vs. 0.7 (0.2-2.0), P = 0.01 ]. Stepwise linear multiple regression analysis indicated that OAI was independently associated with CRP (β coefficient = 0.013, P = 0.001). Sixteen children underwent treatment and there was significant reduction in their serum CRP after intervention [pre vs. post-CRP, 1.3 (0.6-4.1 ) vs. 0.4 (0.2-1.3), P = 0.033]. A significant correlation was also demonstrated between change in CRP and change in OAI (r = 0.593, P = 0.042) following treatment for OSA. Conclusion Children with OSA may have associated systemic inflammation as reflected by a raised CRP that decreased significantly following treatment. © 2007 Wiley-Liss, Inc.