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

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. 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%). 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 ( = .0001 and = .036, respectively). IGF-1 was significantly higher in the non-OSA group ( < .05) and mild OSA group ( < .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 ( < .05) and between mild OSA and severe OSA ( < .001). In the univariate quantile regression analysis of IGF-1, there was a negative relationship between IGF-1 and IL-5 ( < .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. High IL-5 levels may lead to the low secretion of growth hormone level (IGF-1) in children, thus affecting growth and development.