Abstract
Introduction There is growing interest in the use of biomarkers for the diagnosis of Obstructive Sleep Apnea (OSA).
Aims Our aim was to determine if contextualized assay of urinary biomarkers reliably distinguish Primary Snoring (PS) from OSA in children.
Methods We recruited children >2 years with snoring and suspected OSA. Subjects underwent an overnight polysomnogram (PSG). Urine samples collected before (pre-PSG) and after PSG (post-PSG), were centrifuged and stored at -80oC after adding a protease inhibitor cocktail. PSGs were scored as per the AASM 2012 scoring rules. OSA was defined as Obstructive Apnoea Hypopnoea Index (OAHI) >1 (<12 years) or >5 (>12 years). Quantitative analyses of the urinary biomarkers (Uromodulin, Orosomucoid-1 and Kallikrien-1) were done using commercially available ELISA kits.
Results 146 children (mean [SD] age = 9.0 [3.7] years, 70% males) were studied. 11 (7.6%) had PS and 135 (92.4%) had OSA. The pre-PSG urinary biomarkers were not significantly different between PS and OSA in both males and females. The gender wise post-PSG urinary biomarker concentrations in PS and OSA are given in Table 1.
| PS | OSA | |||
| Biomarker | Male (n=7) | Female (n=4) | Male (n=100) | Female (n=35) |
| Kallikrein-1† | 39589 (28903-82394) | 46008 (22967-56953) | 56302 (35887-88311) | 70481 (38449-124313) |
| Orosomucoid-1§ | 896.2 (141.4-1622) | 126.4 (95.3-584.4) | 401.2 (239.8-731) | 433.4 (221-646.2) |
| Uromodulin§ | 3781 (3010-4544) | 6655 (4307-12698) | 5854∗ (3755-8604) | 7265 (4574-10412) |
Data as median (IQR). †pg/ml/mg creatinine, §ng/ml/mg creatinine, *p<0.05 compared to PS (Male)
TABLE 1.
Conclusion Early morning urinary Uromodulin level may distinguish PS from OSA in boys. Further larger studies are required to validate this finding.
- Copyright ©the authors 2016
