Andrew E Bluher, Timothy Kearney, Turaj Vazifedan, Cristina M Baldassari
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Data were analyzed from September 3, 2021, to October 8, 2021.</p><p><strong>Main outcomes and measures: </strong>Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng/mL.</p><p><strong>Results: </strong>The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference, -5.0; 95% CI, -7.2 to -2.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference, 13.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).</p><p><strong>Conclusions: </strong>The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. Future research is needed on vitamin D supplementation and its association with any improvements in pediatric OSA treatment outcomes.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581719/pdf/","citationCount":"0","resultStr":"{\"title\":\"Vitamin D Deficiency and Pediatric Obstructive Sleep Apnea Severity.\",\"authors\":\"Andrew E Bluher, Timothy Kearney, Turaj Vazifedan, Cristina M Baldassari\",\"doi\":\"10.1001/jamaoto.2024.3737\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Prior research has demonstrated an association between vitamin D deficiency and obstructive sleep apnea (OSA) in adults; however, its association with pediatric OSA is emerging.</p><p><strong>Objective: </strong>To evaluate the association of vitamin D levels with obstructive Apnea-Hypopnea Index (AHI) in children with OSA.</p><p><strong>Design, settings, and participants: </strong>This was a cross-sectional study of children aged 2 to 16 years with severe obstructive OSA (AHI ≥20 on polysomnogram) who were undergoing adenotonsillectomy at a tertiary care pediatric otolaryngology clinic from 2017 to 2022. Age, sex, race, body mass index, history of asthma, and season were considered in the analyses. Data were analyzed from September 3, 2021, to October 8, 2021.</p><p><strong>Main outcomes and measures: </strong>Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng/mL.</p><p><strong>Results: </strong>The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference, -5.0; 95% CI, -7.2 to -2.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference, 13.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).</p><p><strong>Conclusions: </strong>The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. 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引用次数: 0
摘要
重要性：先前的研究表明，维生素 D 缺乏与成人阻塞性睡眠呼吸暂停（OSA）之间存在关联；然而，维生素 D 与小儿 OSA 的关联正在逐渐显现：目的：评估维生素 D 水平与 OSA 患儿阻塞性呼吸暂停-低通气指数（AHI）之间的关系：这是一项横断面研究，研究对象为2017年至2022年期间在一家三级医疗机构儿科耳鼻喉科诊所接受腺样体切除术的2至16岁重度阻塞性OSA（多导睡眠图上AHI≥20）患儿。分析中考虑了年龄、性别、种族、体重指数、哮喘病史和季节。数据分析时间为2021年9月3日至2021年10月8日：测量血清 25- 羟维生素 D（25[OH]D）水平，并评估其与多导睡眠图指标的相关性。采集空腹血样，维生素 D 缺乏定义为 25(OH)D 水平低于 20 纳克/毫升：连续样本包括 72 名患者（平均 [SD] 年龄为 6.7 [3.9] 岁；34 [47.2%] 名女性和 38 [52.8%] 名男性）。平均（标清）AHI 为 42.8（25.5），35 人（49.0%）患有肥胖症。27 名参与者（37.5%）缺乏维生素 D。在单变量分析中，维生素 D 缺乏与年龄较小（差异，-5.0；95% CI，-7.2 至 -2.8）、黑人种族（几率比 [OR]，4.3；95% CI，1.4 至 14.3）、女性性别（OR，4.8；95% CI，1.7 至 12.5）和阻塞性 AHI 较高（差异，13.8；95% CI，1.2 至 26.4）有关。在多变量分析中，维生素 D 缺乏仍与 AHI 显著相关。血清 25（OH）D 水平每降低 1.0 单位，AHI 就会增加 0.7（95% CI，0.04 至 1.40）：这项横断面研究的结果表明，维生素 D 缺乏在因严重 OSA 而接受腺扁桃体切除术的儿童中很常见，并且与 OSA 严重程度的增加显著相关。今后需要对维生素 D 的补充及其与改善小儿 OSA 治疗效果的关系进行研究。
Vitamin D Deficiency and Pediatric Obstructive Sleep Apnea Severity.
Importance: Prior research has demonstrated an association between vitamin D deficiency and obstructive sleep apnea (OSA) in adults; however, its association with pediatric OSA is emerging.
Objective: To evaluate the association of vitamin D levels with obstructive Apnea-Hypopnea Index (AHI) in children with OSA.
Design, settings, and participants: This was a cross-sectional study of children aged 2 to 16 years with severe obstructive OSA (AHI ≥20 on polysomnogram) who were undergoing adenotonsillectomy at a tertiary care pediatric otolaryngology clinic from 2017 to 2022. Age, sex, race, body mass index, history of asthma, and season were considered in the analyses. Data were analyzed from September 3, 2021, to October 8, 2021.
Main outcomes and measures: Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng/mL.
Results: The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference, -5.0; 95% CI, -7.2 to -2.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference, 13.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).
Conclusions: The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. Future research is needed on vitamin D supplementation and its association with any improvements in pediatric OSA treatment outcomes.
期刊介绍：
JAMA Otolaryngology–Head & Neck Surgery is a globally recognized and peer-reviewed medical journal dedicated to providing up-to-date information on diseases affecting the head and neck. It originated in 1925 as Archives of Otolaryngology and currently serves as the official publication for the American Head and Neck Society. As part of the prestigious JAMA Network, a collection of reputable general medical and specialty publications, it ensures the highest standards of research and expertise. Physicians and scientists worldwide rely on JAMA Otolaryngology–Head & Neck Surgery for invaluable insights in this specialized field.
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