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Original Research: Sleep Disorders |

Endothelial Function in Children With OSA and the Effects of AdenotonsillectomyEndothelial Function in Children With OSA

Kate C. C. Chan, MB; Chun T. Au, MPhil; Ping Chook, MD; Dennis L. Y. Lee, MB; Hugh S. Lam, MB; Yun K. Wing, MB; Albert Martin Li, MD
Author and Funding Information

From the Department of Pediatrics (Drs Chan, Chook, Lam, and Li, and Mr Au), the Department of Otorhinolaryngology - Head and Neck Surgery (Dr Lee), and the Department of Psychiatry (Dr Wing), Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

CORRESPONDENCE TO: Albert Martin Li, MD, Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing St, Shatin, 000, Hong Kong; e-mail: albertmli@cuhk.edu.hk


Part of this article was presented in abstract form at the Annual Scientific Meeting of the Hong Kong College of Pediatricians, December 7, 2013, Hong Kong.

FUNDING/SUPPORT: This study was supported by the Research Grants Council of the Hong Kong Special Administrative Region, China [CUHK4508/06M].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(1):132-139. doi:10.1378/chest.14-1307
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BACKGROUND:  The association between childhood OSA and endothelial function as measured by flow-mediated dilation (FMD) and its response to OSA treatment are uncertain. The objective of this study was to compare FMD in children with OSA with nonsnoring control subjects and to examine its response to treatment.

METHODS:  Index cases were children aged 6 to 18 years with habitual snoring and polysomnography (PSG)-confirmed OSA (obstructive apnea hypopnea index [OAHI] > 1 events/h). Each case was paired with an age-, sex-, and BMI-matched nonsnoring control subject recruited from our previous community growth survey. All subjects underwent FMD measurement in the morning after overnight PSG. Adenotonsillectomy (AT) was offered to subjects who satisfied predefined AT operation criteria. All cases underwent repeat PSG and FMD assessment 6 months later.

RESULTS:  A total of 63 case-control pairs were recruited. The OSA group had a significantly higher OAHI (median, 5.3 events/h [interquartile range (IQR), 2.6-11.7] vs 0.2 events/h [IQR, 0-0.5], P < .001) and lower FMD (mean ± SD, 7.9% ± 1.3% vs 8.3% ± 0.8%; P = .04) than the control group. Thirty-two case subjects underwent AT. A significant reduction in OAHI was documented in the AT group (−8.8 events/h [IQR, −13.7 to −4.7]; P < .001) accompanied by a significant increase in FMD (+0.6% [IQR, 0.4-1.4]; P < .001), which was not observed in subjects who did not undergo AT.

CONCLUSIONS:  Children with OSA had reduced FMD, which was reversible with treatment.


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