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| 阻塞性睡眠呼吸暂停儿童血清IGF-1水平与认知功能损伤相关性的研究 |
| Obstructive Sleep Apnea in Children: Correlation Between Serum IGF-1 Levels and Cognitive Impairment |
| 投稿时间：2025-05-14 修订日期：2025-05-14 |
| DOI： |
| 中文关键词: 阻塞性睡眠呼吸暂停 儿童 认知功能 胰岛素样生长因子-1 |
| 英文关键词: Obstructive sleep apnea Child Cognitive dysfunction Insulin-like growth factor -I |
| 基金项目: |
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| 摘要点击次数: 28 |
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| 中文摘要: |
| 摘要 目的：探讨阻塞性睡眠呼吸暂停（Obstructive sleep apnea，OSA）疾病对儿童神经认知功能的影响，分析血清胰岛素样生长因子-1（insulin-like growth factor-1，IGF-1）表达水平与OSA患儿认知功能损伤的相关性。方法：收集2023年-2024年就诊于山西医科大学第一医院,年龄为3-16岁、有打鼾或张口呼吸症状且病史大于一年的135名儿童为研究对象，均完成整夜多导睡眠监测（Polysomnography，PSG）、血清IGF-1浓度测定及中国修订版的韦氏儿童智力量表（Wechsler Intelligence Scale for Children，WISC）或韦氏幼儿智力量表（Wechsler Younger Children Scale of Intelligence ，WYCSI）、注意缺陷多动障碍评定量表第四版（Swanson Nolan and Pelham, version IV scale，SNAP–IV）父母版量表。同时收集年龄和性别匹配的无打鼾儿童28例为对照组。比较以上相关指标。结果：对照组与OSA组儿童性别、年龄无统计学差异（P＞0.05），OSA组儿童BMI值高于对照组，且重度OSA组BMI值高于轻度OSA，均有统计学差异（P＜0.05）。OSA组儿童血清IGF-1水平高于对照组，具有统计学差异（P＜0.05），OSA各组血清IGF-1值依次降低，但未达到统计差异（P＞0.05）。重度OSA组患儿韦氏总智商得分低于轻度OSA组，SNAP-IV量表注意力不足、多动/冲动、对立违抗量表得分高于中度和轻度OSA组，且具有统计学差异（P＜0.05）。OSA患儿OAHI值与韦氏量表总智商分呈负相关（r=-0.282，P＜0.001）；与SNAP-IV量表中注意力不集中（r=0.297，P＜0.001）、多动/冲动（r=0.272，P＜0.001）、对立违抗（r=0.283，P＜0.001）得分呈正相关。OSA患儿血清IGF-1水平与韦氏量表总智（FIQ）得分呈正相关（r=0.372，P＜0.001），与SNAP-IV量表注意力不集中（r=-0.368，P＜0.001）、多动/冲动（r=-0.364，P＜0.001）、对立违抗量表得分（r=-0.270，P=0.002）呈负相关。结论：肥胖是儿童OSA的易感因素，疾病严重程度重的患儿BMI值高；OSA对儿童认知功能产生负面影响，主要体现在注意力和多动/冲动维度上，且阻塞程度越重这种影响越明显，提倡尽早干预；IGF-1参与了OSA儿童早期认知功能的保护，IGF-1的水平可能为OSA儿童认知功能损伤提供风险评估。血清IGF-1水平下降可能是OSA患儿认知功能损伤的机制之一。 |
| 英文摘要: |
| Abstract Objective:To investigate the neurocognitive effects of obstructive sleep apnea (OSA) in children and analyze the correlation between serum insulin-like growth factor-1 (IGF-1) levels and cognitive impairment in pediatric OSA patients. Methods:This study enrolled 135 children aged 3–16 years with chronic snoring or mouth-breathing symptoms (>1 year duration) from the First Hospital of Shanxi Medical University (2023–2024). All participants underwent standardized overnight polysomnography (PSG), serum IGF-1 quantification, and neurocognitive evaluations using the Chinese-revised Wechsler Intelligence Scale for Children (WISC) or Wechsler Younger Children Scale of Intelligence (WYCSI), and Swanson Nolan and Pelham Version IV Scale (SNAP-IV) . A control group of 28 age- and sex-matched children without snoring symptoms was included for comparison.Compare the aforementioned relevant indicators.Results:There was no statistically significant difference in gender and age between the control group and the OSA group (P > 0.05). The BMI of children in the OSA group was higher than that of the control group, and the BMI of children in the severe OSA group was higher than that of the mild OSA group, both with statistical significance (P < 0.05). The serum IGF-1 level of children in the OSA group was higher than that of the control group, with statistical significance (P < 0.05). The serum IGF-1 values of the OSA groups decreased in sequence, but the difference was not statistically significant (P > 0.05). The full scale intelligence quotient (FIQ) scores on the Wechsler scales in the severe OSA group was lower than that of the mild OSA group, and the scores of the inattention, hyperactivity/impulsivity, and oppositional defiant scales of the SNAP-IV scale were higher than those of the moderate and mild OSA groups, with statistical significance (P < 0.05). The OAHI of OSA children was negatively correlated with the FIQ score of the Wechsler scale (r = -0.282, P < 0.001), and positively correlated with the scores of inattention (r = 0.297, P < 0.001), hyperactivity/impulsivity (r = 0.272, P < 0.001), and oppositional defiant (r = 0.283, P < 0.001) of the SNAP-IV scale. The serum IGF-1 level of OSA children was positively correlated with the FIQ score of the Wechsler scale (r = 0.372, P < 0.001), and negatively correlated with the scores of inattention (r = -0.368, P < 0.001), hyperactivity/impulsivity (r = -0.364, P < 0.001), and oppositional defiant (r = -0.270, P = 0.002) of the SNAP-IV scale. Conclusion: Obesity is a predisposing factor for pediatric OSA, with higher BMI linked to disease severity. OSA has a negative impact on children's cognitive function, mainly reflected in the dimensions of attention and hyperactivity/impulsivity, with the impact becoming more pronounced as the severity of obstruction increases, underscoring the importance of early intervention. IGF-1 is involved in the protection of early cognitive function in children with OSA, and the level of IGF-1 may provide a risk assessment for cognitive function impairment in children with OSA. The decrease in serum IGF-1 level may be one of the mechanisms of cognitive function impairment in children with OSA. |
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