OBJECTIVE: Children with obstructive sleep apnea syndrome (OSAS) have increased systemic inflammation, as assessed by c-reactive protein (CRP), and are at risk for substantial end-organ damage. Previous studies assessing the effect of adenotonsillectomy (T&A) on CRP in children with OSAS have yielded conflicting results. Therefore, the purpose of the current investigation was to perform a meta-analysis of the effect of T&A on CRP in children with OSAS and explore possible moderating factors. METHODS: Multiple databases (PubMed, CINAHL, and Cochrane) were searched for relevant studies. Effective size was calculated with standardized mean differences (SMD) and analyzed with random-effects model. Moderators were examined with mixed-effects models. RESULTS: Overall, T&A significantly reduced CRP (SMD=-0.79, 95% CI -1.33 to -0.25). We found significant between-study heterogeneity (Cochran's Q=54.6, df=7, p<0.001; I2=90.7%, 95% CI 77.5-98.2%; and H2=10.7, 95% CI 4.5-55.7). We did not find evidence of publication bias or significant effects of tested moderators (study year, study size, age, gender, obesity, apnea-hypopnea index, oxygen nadir, pre-surgical CRP, follow-up duration). CONCLUSIONS: The results of the current study indicate that T&A significantly reduces CRP levels in children with OSAS. Despite the presence of significant between-study heterogeneity, we did not identify any significant moderating factors. Published by Elsevier B.V.
OBJECTIVE:Children with obstructive sleep apnea syndrome (OSAS) have increased systemic inflammation, as assessed by c-reactive protein (CRP), and are at risk for substantial end-organ damage. Previous studies assessing the effect of adenotonsillectomy (T&A) on CRP in children with OSAS have yielded conflicting results. Therefore, the purpose of the current investigation was to perform a meta-analysis of the effect of T&A on CRP in children with OSAS and explore possible moderating factors. METHODS: Multiple databases (PubMed, CINAHL, and Cochrane) were searched for relevant studies. Effective size was calculated with standardized mean differences (SMD) and analyzed with random-effects model. Moderators were examined with mixed-effects models. RESULTS: Overall, T&A significantly reduced CRP (SMD=-0.79, 95% CI -1.33 to -0.25). We found significant between-study heterogeneity (Cochran's Q=54.6, df=7, p<0.001; I2=90.7%, 95% CI 77.5-98.2%; and H2=10.7, 95% CI 4.5-55.7). We did not find evidence of publication bias or significant effects of tested moderators (study year, study size, age, gender, obesity, apnea-hypopnea index, oxygen nadir, pre-surgical CRP, follow-up duration). CONCLUSIONS: The results of the current study indicate that T&A significantly reduces CRP levels in children with OSAS. Despite the presence of significant between-study heterogeneity, we did not identify any significant moderating factors. Published by Elsevier B.V.
Authors: Daniel Morell-Garcia; Núria Toledo-Pons; Pilar Sanchis; Josep Miquel Bauça; José María Sánchez; José Peña-Zarza; Paloma Giménez; Javier Pierola; Mónica de la Peña-Bravo; Alberto Alonso-Fernández; Antònia Barceló Journal: ERJ Open Res Date: 2020-10-05
Authors: Giampiero Gulotta; Giannicola Iannella; Claudio Vicini; Antonella Polimeni; Antonio Greco; Marco de Vincentiis; Irene Claudia Visconti; Giuseppe Meccariello; Giovanni Cammaroto; Andrea De Vito; Riccardo Gobbi; Chiara Bellini; Elisabetta Firinu; Annalisa Pace; Andrea Colizza; Stefano Pelucchi; Giuseppe Magliulo Journal: Int J Environ Res Public Health Date: 2019-09-04 Impact factor: 3.390