Absence of blood pressure, metabolic, and inflammatory marker changes after adenotonsillectomy for sleep apnea in Greek children

Abstract

Aim Pediatric studies revealed associations of obstructive sleep‐disordered breathing (SDB) with inflammation, metabolic dysfunction, and elevated blood pressure. Evidence about effects of adenotonsillectomy on these abnormalities is scarce. Aim of this investigation was to assess changes in C‐reactive protein (CRP), circulating intercellular adhesion molecule‐1 (cICAM‐1), insulin and blood pressure levels after adenotonsillectomy for SDB in Greek children. Methods Polysomnography was performed pre‐ and postoperatively in children with SDB and controls undergoing adenotonsillectomy for recurrent tonsillitis or otitis. Outcome measures were changes in serum markers and blood pressure. Results Fifty‐eight patients (6.2 ± 2.5 years old) and 17 controls (6.5 ± 2) were studied. After surgery, apnea–hypopnea index (AHI) decreased (mean: −5.9 episodes/hr; 95% confidence interval: −7.8 to −4) in patients. Patients and controls were similar regarding outcomes: CRP (−0.11 mg/dl [−0.25 to 0.02] vs. 0.13 [−0.19 to 0.46]; P = 0.11), cICAM‐1 (−11.6 ng/ml [−38.6 to 15.4] vs. −46.6 [−101.7 to 8.6]; P = 0.23), insulin (2.49 mU/L [0.32–4.67] vs. −0.16 [−2.47 to 2.16]; P = 0.21), systolic blood pressure index (5.2% [2.1–8.3] vs. 10.8 [3.6–17.9]; P = 0.1) and diastolic blood pressure index (−3.2% [−7.2 to 0.8] vs. 2.8 [−5.5 to 11.2]; P = 0.16). Patients with CRP > 0.3 mg/dl had reduced values after AT (P = 0.003) and those with postoperative AHI ≤ 1 had a decrease in diastolic blood pressure (P = 0.02). Conclusions Although adenotonsillectomy improves SDB, it has variable effects on inflammatory and metabolic markers or blood pressure. Pediatr Pulmonol. 2008; 43:550–560.