Obstructive Sleep Apnea in Children Increases Levels of Cytokines Linked to Atherosclerosis in Adults

Published December 2021 | Journal of Pediatrics

Children who have obstructive sleep apnea (OSA) have increased levels of certain proinflammatory cytokines that are linked to atherosclerosis in adulthood, according to research conducted by David Smith, MD, PhD, Raouf Amin, MD, and colleagues. These findings, based on data from 96 children (53 healthy and 43 with OSA), offer details about arterial changes present before atherosclerosis appears. They could help explain the early groundwork of disease.

“The results of our study offer some significant insights into the link between OSA and inflammatory cytokines that we know play a role in cardiovascular disease in adults,” Amin says. “An increase in the levels of these cytokines in children with OSA is an important indicator of the evolving landscape. These cytokines are complex, so our findings provide valuable information.”

To identify cardiovascular differences in children with OSA, the team conducted sleep studies, collected blood samples to measure cytokine levels, and performed ultrasounds to measure the thickness and stiffness of the carotid arteries. The blood tests revealed children with OSA had higher levels of three cytokines associated with atherosclerosis: soluble cluster of differentiation-40 ligand, interleukin-6, and interleukin-8.

While the ultrasound scans did not identify clear differences in carotid arteries between children with OSA and healthy controls, the inflammatory mediators correlated with changes in the structure and function of the carotid arteries. The lack of typical atherosclerotic changes is likely because children have had less time to be impacted by OSA.

“What we’ve discovered about the levels of these cytokines is an important first step toward identifying biomarkers that we already know are linked to atherosclerosis in adults that may also be useful in detecting preclinical cardiovascular changes in kids with OSA,” Amin says.

Being able to successfully make that connection, however, will require longitudinal studies.