Relationship Between The Serum Vitamin D And Abnormal Behavior In Children With Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To investigate the clinical significance of detecting serum vitamin D with obstructive sleep apnea-hypopnea syndrome(OSAHS)in children,by discussing the relationship among serum level of 25(OH)D,apnea-hypopnea index,cognitive function deterioration and lipid indexes.Methods:1.From June 2016 to October 2016,69 children with snoring were divided into the OSAHS group(n=47)and the primary snoring(PS)group(n=22)according to the apnea-hypopnea index(AHI),and 70 healthy children without snoring as control.Venous blood sample was drawn from each child to measure the serum level of 25(OH)D and triglycerides(TG),total cholesterol(TC),high-density lipoprotein(HDL)cholesterol and low-density lipoprotein(LDL)cholesterol.Children behaviors were assessed by Conners Parent Symptom Questionnaire(PSQ).2.Two months after the tonsillectomy and adenoidectomy,serum level of 25(OH)D,sleep monitoring and PSQ were measured again between the OSAHS group and the PS group.Results:1.The mean serum 25(OH)D level of the OSAHS group(17.92±6.32ng/mL)was significantly lower than those of the control group(25.38±10.87ng/mL)(P<0.001),but with no statistical difference between the PS group(22.00±7.84ng/mL)and the control group(P>0.05).2.Non-obese children with OSA had significantly lower 25(OH)D levels than non-obese children without OSA(P=0.001).There were no significant differences between obese children with OSA and non-obese children with OSA(P=0.566).3.The 25(OH)D levels of the OSAHS group showed positive correlations with anxiety(r=0.337,P=0.020),but no significant correlations with and LSaO2,AHI,TG,TC,HDL-C,LDL-C and PSQ except anxiety(r values were<0.5,P>0.05).4.Two months after the operation,the mean serum 25(OH)D level of the PS group and the OSAHS group were(21.44±3.54 ng/mL)and(15.52±7.16 ng/mL).There were no significant differences between preoperative and postoperative in the PS group and the OSAHS group(t=1.062,P=0.30;t=0.92,P=0.38).5.There were significant differences between preoperative and postoperative AHI,LSaO2 and BMI in the OSAHS group(Z=-4.175,P=0.001;Z=-2.656,P=0.008;Z=-4.915,P=0.001).The differences between preoperative and postoperative BMI in PS group were significant(t=-5.510,P=0.001),but with no statistical difference between preoperative and postoperative AHI and LSaO2 in the PS group(Z=-0.785,P=0.432;Z=-0.943,P=0.346).There were also no significant differences between preoperative and postoperative PSQ in the PS group and the OSAHS group(P>0.05).Conclusion:1.This study evidenced a significantly low level of serum 25(OH)D in children with OSAHS.2.The 25(OH)D levels showed positive correlations with anxiety.3.The OSAHS group showed a dramatic improvement in quality of sleep after the operation.BMI in the children with snoring is markedly increasing after the surgery.