Introduction: Adult patients with obstructive sleep apnea (OSA) are at increased risk for cardiovascular disease with prior research demonstrating a link between OSA severity and markers of cardiovascular endothelial pathology, including endocan. Data linking pediatric OSA to cardiovascular sequelae are still emerging. Studies examining cardiovascular biomarkers like endocan in pediatric OSA are lacking. The objective of this study is to assess the association between endocan levels and OSA severity in children.
Methods: In this prospective pilot study, patients 2 to 12 years of age were eligible for inclusion if they were undergoing adenotonsillectomy for OSA, defined as an obstructive apnea-hypopnea index (oAHI) greater than 1 on polysomnogram. Non-snoring patients undergoing otolaryngologic surgery for neck or ear disease were recruited as controls. Patients with asthma, recent upper respiratory infections, or history of utilization of oral corticosteroids within the past month were excluded. An enzyme-linked immunoassay was used to quantify endocan levels.
Results: Twenty-six children with OSA were included in the study along with 14 control patients. The mean age of our study population was 4.8 years old; 13 of patients with OSA (50%) had severe disease (oAHI>10). Patients with OSA had a significantly elevated level of endocan at 6.25 ng/mL when compared to 3.2 ng/mL in controls (p < 0.05). There was a positive correlation between endocan levels and scores on the pediatric sleep questionnaire (r=0.38, p=0.02) and the OSA-18 questionnaire (r=0.36, p=0.03).
Conclusion: Endocan levels are likely elevated in patients with OSA and correlate with severity of symptoms as assessed validated sleep surveys in children. Endocan may serve as an important biomarker for cardiovascular pathology in pediatric OSA. Further research is needed to determine how endocan levels change following pediatric OSA treatment.