Study On Sleep Respiratory Monitoring And Vitamin A And D Levels In Children With Obstructive Sleep Apnea Complicated With Recurrent Respiratory Tract Infection

PurposeTo compare the serum vitamin A and D levels and polysomnography(PSG)parameters in children with obstructive sleep apnea(OSA)with or without recurrent respiratory tract infections(RRTIs),and to explore the role of vitamin A and D in the pathogenesis of OSA combined with RRTIs,and to identify risk factors for OSA combined with RRTIs,To provide theoretical basis for enriching clinical diagnosis and early intervention.MethodsA retrospective study was conducted on the clinical data of 140 OSA patients who were treated in the respiratory department and inpatient department of the Children’s Hospital of Dalian Women and Children’s Medical Center(Group)from January 1,2022 to September 30,2022.Based on whether they were complicated with recurrent respiratory infections,the patients were divided into two groups,with a total of 91 cases in the simple OSA group and 49 cases in the OSA combined with RRTIs group.Record the general condition,serum vitamin A(Vit A),25 hydroxyvitamin D3 [25(OH)D3],vitamin D(Vit D)levels,and sleep breathing monitoring parameters of each group of children.Use SPSS software for inter group comparison,regression analysis,and draw ROC curves.Results1.Basic information: Among the 140 children with OSA,there were 49 cases(35.0%)in the OSA combined with RRTIs group and 91 cases(65.0%)in the simple OSA group;There was no statistically significant difference in gender,age,and BMI between the two groups of children(P>0.05).The proportion of moderate to severe OSA in the OSA combined with RRTIs group was higher than that in the simple OSA group,and the difference was statistically significant(P<0.05);2.Comparison of PSG parameters: The obstructive apnea hypopnea index(OAHI)value of 2.15(1.30,2.60)times/h in the OSA combined with RRTIs group was higher than the OAHI value of 1.60(1.00,2.20)times/h in the simple OSA group,with a statistically significant difference(P<0.05);The apnea hypopnea index(AHI)value of the OSA combined with RRTIs group was 3.50(2.20,4.75)times/h,which was higher than the AHI value of the simple OSA group by 2.65(1.92,3.57)times/h,and the difference was statistically significant(P<0.05);3.Comparison of serum Vit A and Vit D levels: The serum Vit A level in the OSA combined with RRTIs group was 0.26 ± 0.01mg/L,which was lower than the serum Vit A level in the simple OSA group by 0.31 ± 0.01mg/L,with a statistically significant difference(P<0.05);The serum 25(OH)D3 and Vit D levels in the OSA combined with RRTIs group were 14.46 ± 0.73ng/ml and 15.19 ± 0.72ng/ml,respectively,which were lower than those in the simple OSA group [serum 25(OH)D3level 27.40 ± 3.31ng/ml,serum Vit D level 24.93 ± 0.75ng/ml],and the difference was statistically significant(P<0.05);4.Correlation between serum Vit A,Vit D,and PSG parameters: Pearson correlation analysis showed a negative correlation between Vit A and OAHI(r=-0.176,P<0.05);5.Predictive analysis of the possibility of OSA merging with RRTIs: Through logistic regression analysis,we searched for indicators with predictive value for the diagnosis of OSA merging with RRTIs in serum Vit A,Vit D levels,and PSG indicators,and plotted ROC curves.The areas under the curves of obstructive apnea index OAI,25(OH)D3,and Vit D were 0.610(P=0.034),0.877(P<0.01),and 0.874(P<0.01),respectively,The optimal critical values are 0.95 times/h,17.135ng/ml,and17.450ng/ml,respectively,which have predictive value for determining whether OSA merges with RRTIs,with 25(OH)D3 and Vit D having higher predictive value.Conclusions1.The proportion of moderate to severe OSA and OAI in children with OSA combined with RRTIs are higher than those with simple OSA,and the condition of sleep respiratory disorders is more severe;2.The serum Vit A,25(OH)D3,and Vit D levels in children with OSA combined with RRTIs are lower than those in children with OSA alone,and there is a weak negative correlation between serum Vit A and OAHI,indicating that serum Vit A and D may be involved in the pathogenesis of OSA combined with RRTIs;3.The levels of serum 25(OH)D3,Vit D,and OAI have predictive value for OSA with RRTIs.Among them,serum 25(OH)D3 and Vit D have higher predictive value,indicating that in clinical practice,children with OSA are more likely to merge with RRTIs if their serum 25(OH)D3 and Vit D are below the critical value.