Effect of adenotonsillectomy on endothelin-1 and C-reactive protein levels in children with sleep-disordered breathing.

Abstract

This study aimed to evaluate the influence of adenotonsillectomy on the plasma concentration of endothelin-1 (ET-1) and C-reactive protein (CRP) in children with sleep-disordered breathing (SDB). The relationship between quality of life and ET-1 levels was also evaluated. Tertiary referral center. Before-and-after case series. Fasting blood samples for ET-1 and high-sensitivity CRP were drawn preoperatively in all patients and at 3 to 4 months postoperatively. The Obstructive Sleep Apnea-18 (OSA-18) survey and Brouilette symptom score were completed by each child's parents during the same time periods. The mean ET-1 level decreased from 3.51 ± 0.93 fmol/mL to 2.67 ± 0.69 fmol/mL postoperatively (P < .01). OSA-18 survey scores and Brouilette symptom scores also decreased in the postoperative period (P < .01). When comparing moderate and severe cases to mild cases according to Brouilette scores, ET-1 levels were significantly higher in moderate and severe cases (P < .01). There was a significant correlation between ET-1 and the OSA-18 survey scale (r = 0.442; P = .001). Although CRP levels decreased from 0.63 ± 1.19 mg/dL to 0.31 ± 0.23 mg/dL postoperatively, this was not statistically significant. Adenotonsillectomy effectively lowered plasma ET-1 levels in children with SDB and thus may have reduced their related risk for cardiovascular disease. In addition, adenotonsillectomy improved quality of life in this group.