Premium
Absence of blood pressure, metabolic, and inflammatory marker changes after adenotonsillectomy for sleep apnea in Greek children
Author(s) -
Apostolidou Maria T.,
Alexopoulos Emmanouel I.,
Damani Eleni,
Liakos Nikolaos,
Chaidas Konstantinos,
Boultadakis Evangelos,
Apostolidis Theoharis,
Gourgoulianis Konstantinos,
Kaditis Athanasios G.
Publication year - 2008
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20808
Subject(s) - medicine , blood pressure , polysomnography , obstructive sleep apnea , tonsillectomy , c reactive protein , gastroenterology , apnea–hypopnea index , sleep apnea , anesthesia , cardiology , apnea , inflammation
Aim Pediatric studies revealed associations of obstructive sleep‐disordered breathing (SDB) with inflammation, metabolic dysfunction, and elevated blood pressure. Evidence about effects of adenotonsillectomy on these abnormalities is scarce. Aim of this investigation was to assess changes in C‐reactive protein (CRP), circulating intercellular adhesion molecule‐1 (cICAM‐1), insulin and blood pressure levels after adenotonsillectomy for SDB in Greek children. Methods Polysomnography was performed pre‐ and postoperatively in children with SDB and controls undergoing adenotonsillectomy for recurrent tonsillitis or otitis. Outcome measures were changes in serum markers and blood pressure. Results Fifty‐eight patients (6.2 ± 2.5 years old) and 17 controls (6.5 ± 2) were studied. After surgery, apnea–hypopnea index (AHI) decreased (mean: −5.9 episodes/hr; 95% confidence interval: −7.8 to −4) in patients. Patients and controls were similar regarding outcomes: CRP (−0.11 mg/dl [−0.25 to 0.02] vs. 0.13 [−0.19 to 0.46]; P = 0.11), cICAM‐1 (−11.6 ng/ml [−38.6 to 15.4] vs. −46.6 [−101.7 to 8.6]; P = 0.23), insulin (2.49 mU/L [0.32–4.67] vs. −0.16 [−2.47 to 2.16]; P = 0.21), systolic blood pressure index (5.2% [2.1–8.3] vs. 10.8 [3.6–17.9]; P = 0.1) and diastolic blood pressure index (−3.2% [−7.2 to 0.8] vs. 2.8 [−5.5 to 11.2]; P = 0.16). Patients with CRP > 0.3 mg/dl had reduced values after AT ( P = 0.003) and those with postoperative AHI ≤ 1 had a decrease in diastolic blood pressure ( P = 0.02). Conclusions Although adenotonsillectomy improves SDB, it has variable effects on inflammatory and metabolic markers or blood pressure. Pediatr Pulmonol. 2008; 43:550–560. © 2008 Wiley‐Liss, Inc.