PT  - JOURNAL ARTICLE
AU  - Vasiliki Theologi
AU  - Vasiliki Varlami
AU  - Georgia Malakasioti
AU  - Irene Tsilioni
AU  - Konstantinos Chaidas
AU  - Emmanouel Alexopoulos
AU  - Athanasios Kaditis
AU  - Konstantinos Gourgoulianis
TI  - Adiposity but not severity of obstructive sleep-disordered breathing correlates with morning plasma TNF-α levels in Greek children
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - 1394
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/1394.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/1394.full
SO  - Eur Respir J2012 Sep 01; 40
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.