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Original Research: SLEEP MEDICINE |

Urine Concentrations of Cysteinyl Leukotrienes in Children With Obstructive Sleep-Disordered Breathing

Athanasios G. Kaditis, MD; Emmanouel Alexopoulos, MD; Konstantinos Chaidas, MD; Georgia Ntamagka, MD; Anastasia Karathanasi, MD; Irene Tsilioni, BS; Theodoros S. Kiropoulos, BS; Elias Zintzaras, MSc, PhD; Konstantinos Gourgoulianis, MD
Author and Funding Information

*From the Sleep Disorders Laboratory (Drs. Kaditis, Alexopoulos, Chaidas, Ntamagka, Karathanasi, and Gourgoulianis, Ms. Tsilioni, and Mr. Kiropoulos), and the Department of Biomathematics (Dr. Zintzaras), University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece.

Correspondence to: Athanasios Kaditis, MD, 31 Theatrou St, Piraeus 18534, Greece; e-mail: Kaditia@hotmail.com


This research was funded by the University of Thessaly Research Committee.

The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;135(6):1496-1501. doi:10.1378/chest.08-2295
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Background:  Adenotonsillar tissue of children with obstructive sleep-disordered breathing (SDB) has increased content of cysteinyl leukotrienes (CysLTs) and expression of CysLTs receptors. Furthermore, CysLTs concentrations in the nasal exhaled breath condensate of children with sleep apnea are elevated.

Objective:  To investigate the relationship between urine levels of CysLTs and severity of SDB in children.

Methods:  Morning urine concentrations of CysLTs were measured in children with symptoms of SDB and in control subjects with recurrent tonsillitis and without snoring who underwent polysomnography and were expressed in pg/mL per mg/dL of urine creatinine.

Results:  Nineteen children with moderate-to-severe SDB (mean [± SD] age, 5.4 ± 1.6 years; obstructive apnea-hypopnea index [OAHI]: 14.4 ± 9.6 episodes/h), 29 subjects with mild SDB (5.1 ± 1.5 years; OAHI: 2.9 ± 0.8 episodes/h), 26 children with primary snoring (PS) [7 ± 2.6 years; OAHI: 1.1 ± 0.3 episodes/h], and 18 control subjects (6.4 ± 2.5 years; OAHI: 0.7 ± 0.3 episodes/h) were studied. Children with moderate-to severe SDB had higher log-transformed urine CysLTs levels than those with mild SDB, PS, or control subjects (2.39 ± 0.51 vs 2.06 ± 0.26 vs 2.11 ± 0.25 vs 1.86 ± 0.28; p < 0.05). Log-transformed CysLTs concentration, tonsillar size, and body mass index z score were significant predictors of log-transformed OAHI (p < 0.01).

Conclusions:  Urine excretion of CysLTs is related to SDB severity in children. This finding indicates that 5-lipoxygenase pathway products participate in the pathogenesis of obstructive sleep apnea in childhood or alternatively that SDB promotes CysLTs biosynthesis.

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