Exploratory Study of Relationship Between Obstructive Sleep Apnea Syndrome and Growth Hormones and Inflammatory Factors in Children

Abstract

Purpose: In children, obstructive sleep apnea (OSA) is associated with growth hormone level abnormalities and chronic systemic inflammation. This study was performed to investigate the relationship of the degree of OSA with insulin-like growth factor 1 (IGF-1) and inflammatory cytokines in pediatric OSA and the inter-relationship between inflammatory cytokines and growth hormones. Methods: Children with OSA and controls without OSA participated in the study. Information included polysomnography followed by measurement of IGF-1 and inflammatory marker levels. In total, 226 patients aged 2 to 12 years were divided into 4 groups: non-OSA, n = 57 (25.2%); mild OSA, n = 116 (51.3%); moderate OSA, n = 23 (10.2%); and severe OSA, n = 30 (13.3%). Results: Body height was not significantly different among the 4 groups. However, the minimum oxygen saturation and IGF-1 significantly differed among the different OSA groups ( P = .0001 and P = .036, respectively). IGF-1 was significantly higher in the non-OSA group ( P < .05) and mild OSA group ( P < .01) than in the severe OSA group. As the severity of OSA increased, the interleukin-5 level significantly increased, which caused a difference between mild OSA and moderate OSA ( P < .05) and between mild OSA and severe OSA ( P < .001). In the univariate quantile regression analysis of IGF-1, there was a negative relationship between IGF-1 and IL-5 ( P < .001). IGF-1 was positively correlated with age, height, and minimum oxygen saturation. Furthermore, there was a negative correlation between the IGF-1 level and the severity of OSA. Quantile regression analysis on the multivariable analysis of the IGF-1 association showed that height, sex, and severity of OSA played important roles in affecting IGF-1 levels. Conclusion: High IL-5 levels may lead to the low secretion of growth hormone level (IGF-1) in children, thus affecting growth and development.