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Sleep Med. 2013 Feb;14(2):172-6. doi: 10.1016/j.sleep.2012.11.011. Epub 2013 Jan 11.

Effect of adenotonsillectomy on c-reactive protein levels in children with obstructive sleep apnea: a meta-analysis.

Author information

1
American Family Children's Hospital, Madison, WI, USA. dingram@uwhealth.org

Abstract

OBJECTIVE:

Children with obstructive sleep apnea syndrome (OSAS) have increased systemic inflammation, as assessed by c-reactive protein (CRP), and are at risk for substantial end-organ damage. Previous studies assessing the effect of adenotonsillectomy (T&A) on CRP in children with OSAS have yielded conflicting results. Therefore, the purpose of the current investigation was to perform a meta-analysis of the effect of T&A on CRP in children with OSAS and explore possible moderating factors.

METHODS:

Multiple databases (PubMed, CINAHL, and Cochrane) were searched for relevant studies. Effective size was calculated with standardized mean differences (SMD) and analyzed with random-effects model. Moderators were examined with mixed-effects models.

RESULTS:

Overall, T&A significantly reduced CRP (SMD=-0.79, 95% CI -1.33 to -0.25). We found significant between-study heterogeneity (Cochran's Q=54.6, df=7, p<0.001; I2=90.7%, 95% CI 77.5-98.2%; and H2=10.7, 95% CI 4.5-55.7). We did not find evidence of publication bias or significant effects of tested moderators (study year, study size, age, gender, obesity, apnea-hypopnea index, oxygen nadir, pre-surgical CRP, follow-up duration).

CONCLUSIONS:

The results of the current study indicate that T&A significantly reduces CRP levels in children with OSAS. Despite the presence of significant between-study heterogeneity, we did not identify any significant moderating factors.

PMID:
23317933
DOI:
10.1016/j.sleep.2012.11.011
[Indexed for MEDLINE]

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