0869 CRP IS A BETTER PREDICTOR OF CARDIOMETABOLIC RISK THAN APNEA/HYPOPNEA INDEX IN ADOLESCENTS WITH MILD-TO-MODERATE OBSTRUCTIVE SLEEP APNEA

Abstract

The guidelines for when and how to treat mild-to-moderate obstructive sleep apnea (OSA) in adolescents are often a clinically gray area. We examined the relative contribution of apnea/hypopnea index (AHI) vs. C-reactive protein (CRP) in predicting cardiometabolic risk in a general population sample of adolescents with mild-to-moderate OSA. Adolescents from the Penn State Child Cohort underwent a single 9h polysomnography. Those with mild-to-moderate OSA (2≤AHI<15) were included in the study (n=135; ages 12-22y, 66.7% male, BMI percentile 72.6 ± 2.3). A fasting blood draw was taken upon awakening (7:00), and plasma levels of CRP, glucose, insulin, HDL cholesterol, and triglycerides were measured. Blood pressure (BP) was assessed in the evening while seated. Linear regression models examined the relative contribution of CRP and AHI in predicting cardiometabolic health, adjusting for age, sex, and ethnic minority. In adolescents with mild-to-moderate OSA, CRP was a stronger predictor of diastolic BP (β=0.15, p=0.09), glucose (β=0.22, p=0.01), insulin resistance (homeostatic model assessment [HOMA]; β=0.20, p=0.02), triglycerides (β=0.16, p=0.08), and the continuous metabolic syndrome risk score (cMetS; β=0.29, p=0.001), than AHI (all p>0.16). These associations of CRP with cardiometabolic risk were stronger within mild-to-moderate OSA compared to the full sample of adolescents with AHI<15 (n=364), where only insulin resistance (β=0.16, p=0.004), triglycerides (β=0.14, p=0.01), and cMetS (β=0.23, p<0.001) were predicted by CRP, and not AHI (all p>0.487). Incorporating a measure of systemic inflammation improves the ability for clinicians to detect cases of mild-to-moderate OSA with true cardiometabolic risk in adolescents. These findings have implications in improving prognosis and treatment options for adolescents with OSA in the mild-to-moderate range. NIH R01 HL63772, R01 HL97165, UL1 TR000127, C06 RR16499