RT Journal Article SR Electronic T1 Adiposity but not severity of obstructive sleep-disordered breathing correlates with morning plasma TNF-α levels in Greek children JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1394 VO 40 IS Suppl 56 A1 Vasiliki Theologi A1 Vasiliki Varlami A1 Georgia Malakasioti A1 Irene Tsilioni A1 Konstantinos Chaidas A1 Emmanouel Alexopoulos A1 Athanasios Kaditis A1 Konstantinos Gourgoulianis YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/1394.abstract AB Background: Sleep-disordered breathing (SDB) has been associated with increased frequency of excessive daytime sleepiness (EDS). In adults, increased TNF-α plasma levels probably mediate this association, but conflicting results have been reported in children. We hypothesized that: i) the higher the severity of SDB in childhood, the higher the frequency of EDS and morning TNF-α plasma levels; ii) subjects with high TNF-α levels are more likely to have EDS. Methods: Children without and with snoring underwent polysomnography, EDS was determined by parental response to specific questions and TNF-α morning plasma levels were measured. Results: Children with moderate-to-severe SDB [n=24; 5.7±2 yo; apnea-hypopnea index (AHI) 6-23.5 episodes/hour), but not participants with mild SDB (n=22; 6±2.5 yo; AHI 1.1-4.7) were at significantly higher risk for EDS compared to controls without snoring (n=26; 6.2±2.3 yo; AHI 0.2-1) [OR (95% CI): 7 (1.6-30.9) and 3 (0.6-13.8), respectively]. The 3 groups did not differ regarding TNF-α levels (0.63±0.2 vs. 0.65±0.2 vs. 0.57±0.13 pg/mL; p>0.05). TNF-α levels were associated significantly with body mass index z-score (p<0.05), but not AHI or SpO2 nadir (p>0.05). Subjects with high TNF-α levels (>0.57 pg/mL i.e. median in controls) were not at higher risk for EDS compared to those with low levels [OR (95% CI) adjusted for obesity: 1.9 (0.6-6.4)]. Conclusions: Increasing severity of SDB is related to increasing frequency of EDS but not with elevated TNF-α plasma concentrations which are positively correlated with the degree of adiposity. Children with high TNF-α levels are not at increased risk for EDS.