The evaluation of adenotonsillectomy on TNF-α and IL-6 levels in obese children with obstructive sleep apnea

• Published in: International journal of pediatric otorhinolaryngology Vol. 77; no. 5; pp. 690 - 694
• Main Authors: Chu, Lijuan, Li, Qiuhong
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.05.2013
• Subjects: Adenoidectomy; Adenotonsillectomy; Body Mass Index; Child; Child, Preschool; Female; Humans; IL-6; Interleukin-6 - blood; Male; Obese children; Obesity - complications; OSA; Otolaryngology; Pediatrics; Polysomnography; Severity of Illness Index; Sleep Apnea, Obstructive - blood; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - surgery; TNF-α; Tonsillectomy; Tumor Necrosis Factor-alpha - blood; Adenotonsillectomy; TNF-α; OSA; Obese children; IL-6
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2013.01.019

Abstract Objective (1) To evaluate the effect of adenotonsillectomy (T&A) on clinical signs in obese children with obstructive sleep apnea (OSA); (2) to evaluate the changes in tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 levels pre- and post-surgery; and (3) to determine a potential explanation for changes in cytokine levels after T&A therapy. Subjects and methods In brief, 90 obese children with OSA were enrolled. Polysomnographic data, such as an apnea–hypopnea index (AHI) and oxyhemoglobin saturation (SaO2 ), and demographic information, such as body mass index (BMI), were collected. TNF-α and IL-6 levels were determined before and 6 months after T&A treatment. Results It was observed that 61.1% of obese children with OSA were persistent after T&A therapy. In general, AHI (events/h) measures decreased from 22.26 ± 9.141 to 8.88 ± 5.909 before and after a 6-month follow-up period, respectively, and nadir SaO2 (%) levels increased from 74.26 ± 7.486 to 86.37 ± 5.578 pre- and post-surgery, respectively. However, no discernible differences in BMI measures before and after a 6-month follow-up period (40.996 ± 5.2486 vs. 40.597 ± 5.0540) were observed. No significant differences in the TNF-α and IL-6 levels pre- and post-surgery were observed. TNF-α and IL-6 plasma levels were highly correlated with BMI measurements (TNF-α: r2 = 0.2350, P < 0.001; IL-6: r2 = 0.6629, P < 0.001). In contrast, there was no association between plasma levels and AHI measures (TNF-α: r2 = 0.03377, P = 0.0829; IL-6: r2 = 0.03946, P = 0.0605). Conclusion T&A therapy can improve clinical symptoms and signs but is not a cure for the treatment of obese children with OSA. The inflammation levels of TNF-α and IL-6 changed little. To reduce the risk for excessive daytime sleepiness, supplementary therapies should be introduced for OSA.