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Published in: BMC Pediatrics 1/2020

01-12-2020 | Snoring | Research article

Mean platelet volume levels in children with sleep-disordered breathing: a meta-analysis

Authors: Wen-Dien Chang, Chih-Hao Tseng, Yung-An Tsou

Published in: BMC Pediatrics | Issue 1/2020

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Abstract

Background

Pediatric sleep-disordered breathing (SDB) correlated with respiratory conditions of snoring and hypopnea. Mean platelet volume (MPV) was an inflammatory marker, related to increased inflammatory condition of pediatric patients. Increase of MPV level may cause failure to thrive or increased upper airway infection rate. The aim of this study was to perform systematic review and meta-analysis to investigate the difference on MPV values for pediatric SDB, and compare the change on MPV after surgery in patients with pediatric SDB.

Methods

A systemic review of the studies from PubMed, EMBASE, and Cochrane Library databases was conducted in March 2020, supported by reviewing of published articles for studies comparing MPV in pediatric SDB. Meta-analysis was used to compare the change of MPV in pediatric SDB, and sub-group analysis was also used to compare the MPV decrease after surgeries of adenoidectomy or adenotonsillectomy.

Results

There were seven studies included in the review. Six of them including 963 subjects showed that a significant increase of MPV was noted in pediatric SDB compared to those in pediatric non-SDB (P < 0.05). Total standardized mean difference (SMD) in MPV between pediatric SDB and non-SDB was 0.51 (95% CI =0.30–0.72, P < 0.05). A significant decrease of MPV was found in pediatric SDB patients who underwent surgery (total SMD = − 0.36; 95% CI = − 0.70– -0.02, P < 0.05). Decreases of MPV after adenoidectomy and adenotonsillectomy were observed, but only the effect of adenotonsillectomy had a statistical significance (total SMD = − 0.72; 95% CI = − 1.18 – -0.26, P < 0.05).

Conclusion

The MPV was significantly higher in patients with pediatric SDB, indicating the presence of increased platelet activity in pediatric SDB patients. The level of MPV could be reduced by the two surgeries, especially adenotonsillectomy.
Literature
1.
go back to reference Johnston J, McLaren H, Mahadevan M, Douglas RG. Clinical characteristics of obstructive sleep apnea versus infectious adenotonsillar hyperplasia in children. Int J Pediatr Otorhinolaryngol. 2019;116:177–80.CrossRef Johnston J, McLaren H, Mahadevan M, Douglas RG. Clinical characteristics of obstructive sleep apnea versus infectious adenotonsillar hyperplasia in children. Int J Pediatr Otorhinolaryngol. 2019;116:177–80.CrossRef
2.
go back to reference Sedky K, Bennett DS, Carvalho KS. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev. 2014;18:349–56.CrossRef Sedky K, Bennett DS, Carvalho KS. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev. 2014;18:349–56.CrossRef
3.
go back to reference Esteller E, Villatoro JC, Agüero A, Lopez R, Matiñó E, Argemi J, Girabent-Farrés M. Obstructive sleep apnea syndrome and growth failure. Int J Pediatr Otorhinolaryngol. 2018;108:214–8.CrossRef Esteller E, Villatoro JC, Agüero A, Lopez R, Matiñó E, Argemi J, Girabent-Farrés M. Obstructive sleep apnea syndrome and growth failure. Int J Pediatr Otorhinolaryngol. 2018;108:214–8.CrossRef
4.
go back to reference Lee CH, Kang KT, Chiu SN, Chang IS, Weng WC, Lee PL, Hsu WC. Association of adenotonsillectomy with blood pressure among hypertensive and nonhypertensive children with obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg. 2018;144:300–7.CrossRef Lee CH, Kang KT, Chiu SN, Chang IS, Weng WC, Lee PL, Hsu WC. Association of adenotonsillectomy with blood pressure among hypertensive and nonhypertensive children with obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg. 2018;144:300–7.CrossRef
5.
go back to reference Lee LA, Li HY, Lin YS, Fang TJ, Huang YS, Hsu JF, Wu CM, Huang CG. Severity of childhood obstructive sleep apnea and hypertension improved after adenotonsillectomy. Otolaryngol Head Neck Surg. 2015;152:553–60.CrossRef Lee LA, Li HY, Lin YS, Fang TJ, Huang YS, Hsu JF, Wu CM, Huang CG. Severity of childhood obstructive sleep apnea and hypertension improved after adenotonsillectomy. Otolaryngol Head Neck Surg. 2015;152:553–60.CrossRef
6.
go back to reference Li Z, Celestin J, Lockey RF. Pediatric sleep apnea syndrome: an update. J Allergy Clin Immunol Pract. 2016;4:852–61.CrossRef Li Z, Celestin J, Lockey RF. Pediatric sleep apnea syndrome: an update. J Allergy Clin Immunol Pract. 2016;4:852–61.CrossRef
7.
go back to reference Papapanagiotou A, Daskalakis G, Siasos G, Gargalionis A, Papavassiliou AG. The role of platelets in cardiovascular disease: molecular mechanisms. Curr Pharm Des. 2016;22:4493–505.CrossRef Papapanagiotou A, Daskalakis G, Siasos G, Gargalionis A, Papavassiliou AG. The role of platelets in cardiovascular disease: molecular mechanisms. Curr Pharm Des. 2016;22:4493–505.CrossRef
8.
go back to reference Ibrahim H, Kleiman NS. Platelet pathophysiology, pharmacology, and function in coronary artery disease. Coron Artery Dis. 2017;28:614–23.CrossRef Ibrahim H, Kleiman NS. Platelet pathophysiology, pharmacology, and function in coronary artery disease. Coron Artery Dis. 2017;28:614–23.CrossRef
9.
go back to reference Hudzik B, Korzonek-Szlacheta I, Szkodziński J, Liszka R, Lekston A, Zubelewicz-Szkodzińska B, Gąsior M. Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction. Acta Diabetol. 2018;55:175–83.CrossRef Hudzik B, Korzonek-Szlacheta I, Szkodziński J, Liszka R, Lekston A, Zubelewicz-Szkodzińska B, Gąsior M. Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction. Acta Diabetol. 2018;55:175–83.CrossRef
10.
go back to reference Uçar H, Gür M, Gözükara MY, Kıvrak A, Kolcu Z, Akyol S, Kaypaklı O, Elbasan Z, Şahin DY, Türkoğlu C, Şeker T, Çaylı M. Relationship between mean platelet volume and morning blood pressure surge in newly diagnosed hypertensive patients. Anatol J Cardiol. 2015;15:107–12.CrossRef Uçar H, Gür M, Gözükara MY, Kıvrak A, Kolcu Z, Akyol S, Kaypaklı O, Elbasan Z, Şahin DY, Türkoğlu C, Şeker T, Çaylı M. Relationship between mean platelet volume and morning blood pressure surge in newly diagnosed hypertensive patients. Anatol J Cardiol. 2015;15:107–12.CrossRef
11.
go back to reference Hartmann LT, Alegretti AP, Machado ABMP, Martins EF, da Silva Chakr RM, Gasparin AA, Monticielo OA. Assessment of mean platelet volume in patients with systemic lupus erythematosus. Open Rheumatol J. 2018;12:129–38.CrossRef Hartmann LT, Alegretti AP, Machado ABMP, Martins EF, da Silva Chakr RM, Gasparin AA, Monticielo OA. Assessment of mean platelet volume in patients with systemic lupus erythematosus. Open Rheumatol J. 2018;12:129–38.CrossRef
12.
go back to reference Berger JS, Eraso LH, Xie D, Sha D, Mohler ER. Mean platelet volume and prevalence of peripheral artery disease, the National Health and nutrition examination survey, 1999-2004. Atherosclerosis. 2010;213:586–91.CrossRef Berger JS, Eraso LH, Xie D, Sha D, Mohler ER. Mean platelet volume and prevalence of peripheral artery disease, the National Health and nutrition examination survey, 1999-2004. Atherosclerosis. 2010;213:586–91.CrossRef
13.
go back to reference Zhao F, Yan Z, Meng Z, Li X, Liu M, Ren X, Zhu M, He Q, Zhang Q, Song K, Jia Q, Zhang C, Wang H, Liu X, Zhang X, Wang X, Pan Z, Liu X, Zhang W. Relationship between mean platelet volume and metabolic syndrome in Chinese patients. Sci Rep. 2018;8:14574.CrossRef Zhao F, Yan Z, Meng Z, Li X, Liu M, Ren X, Zhu M, He Q, Zhang Q, Song K, Jia Q, Zhang C, Wang H, Liu X, Zhang X, Wang X, Pan Z, Liu X, Zhang W. Relationship between mean platelet volume and metabolic syndrome in Chinese patients. Sci Rep. 2018;8:14574.CrossRef
14.
go back to reference Panova-Noeva M, Arnold N, Hermanns MI, Prochaska JH, Schulz A, Spronk HM, Binder H, Pfeiffer N, Beutel M, Blankenberg S, Zeller T, Lotz J, Münzel T, Lackner KJ, Ten Cate H, Wild PS. Mean platelet volume and arterial stiffness- clinical relationship and common genetic variability. Sci Rep. 2017;7:40229.CrossRef Panova-Noeva M, Arnold N, Hermanns MI, Prochaska JH, Schulz A, Spronk HM, Binder H, Pfeiffer N, Beutel M, Blankenberg S, Zeller T, Lotz J, Münzel T, Lackner KJ, Ten Cate H, Wild PS. Mean platelet volume and arterial stiffness- clinical relationship and common genetic variability. Sci Rep. 2017;7:40229.CrossRef
15.
go back to reference Archontogeorgis K, Voulgaris A, Papanas N, Nena E, Froudarakis M, Mikhailidis DP, Steiropoulos P. Mean platelet volume and platelet distribution width in patients with obstructive sleep apnea syndrome and concurrent chronic obstructive pulmonary disease. Clin Appl Thromb Hemost. 2018;24:1216–22.CrossRef Archontogeorgis K, Voulgaris A, Papanas N, Nena E, Froudarakis M, Mikhailidis DP, Steiropoulos P. Mean platelet volume and platelet distribution width in patients with obstructive sleep apnea syndrome and concurrent chronic obstructive pulmonary disease. Clin Appl Thromb Hemost. 2018;24:1216–22.CrossRef
16.
go back to reference Sarioglu N, Demirpolat G, Erel F, Kose M. Which is the ideal marker for early atherosclerosis in obstructive sleep apnea- carotid intima-media thickness or mean platelet volume? Med Sci Monit. 2017;23:1674–81.CrossRef Sarioglu N, Demirpolat G, Erel F, Kose M. Which is the ideal marker for early atherosclerosis in obstructive sleep apnea- carotid intima-media thickness or mean platelet volume? Med Sci Monit. 2017;23:1674–81.CrossRef
17.
go back to reference Esen E, Özdoğan F, Özel HE, Yılmaz Z, Yüce T, Başer S, Genç S, Selçuk A. Mean platelet volume play a role in disease severity in patients with obstructive sleep apnea syndrome? Kulak Burun Bogaz Ihtis Derg. 2015;25:343–5.CrossRef Esen E, Özdoğan F, Özel HE, Yılmaz Z, Yüce T, Başer S, Genç S, Selçuk A. Mean platelet volume play a role in disease severity in patients with obstructive sleep apnea syndrome? Kulak Burun Bogaz Ihtis Derg. 2015;25:343–5.CrossRef
18.
go back to reference Feliciano A, Linhas R, Marçôa R, Cysneiros A, Martinho C, Reis RP, Penque D, Pinto P, Bárbara C. Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure. Rev Port Pneumol. 2017;23:71–8.PubMed Feliciano A, Linhas R, Marçôa R, Cysneiros A, Martinho C, Reis RP, Penque D, Pinto P, Bárbara C. Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure. Rev Port Pneumol. 2017;23:71–8.PubMed
19.
go back to reference Simsek G, Haytoglu S, Muluk NB, Arikan OK, Cortuk M, Kiraz K. Mean platelet volume decreases in adult patients with obstructive sleep apnea after uvulopalatal flap surgery. J Craniofac Surg. 2015;26:2152–4.CrossRef Simsek G, Haytoglu S, Muluk NB, Arikan OK, Cortuk M, Kiraz K. Mean platelet volume decreases in adult patients with obstructive sleep apnea after uvulopalatal flap surgery. J Craniofac Surg. 2015;26:2152–4.CrossRef
20.
go back to reference Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.CrossRef Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.CrossRef
21.
go back to reference Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.CrossRef Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.CrossRef
22.
go back to reference Rosenthal R. The file drawer problem and tolerance for null results. Psychol Bull. 1979;86:638–41.CrossRef Rosenthal R. The file drawer problem and tolerance for null results. Psychol Bull. 1979;86:638–41.CrossRef
23.
go back to reference Kucur C, Kulekci S, Zorlu A, Savran B, Oghan F, Yildirim N. Mean platelet volume levels in children with adenoid hypertrophy. J Craniofac Surg. 2014;25:29–31.CrossRef Kucur C, Kulekci S, Zorlu A, Savran B, Oghan F, Yildirim N. Mean platelet volume levels in children with adenoid hypertrophy. J Craniofac Surg. 2014;25:29–31.CrossRef
24.
go back to reference Onder S, Caypinar B, Sahin-Yilmaz A, Toros SZ, Oysu C. Relation of mean platelet volume with obstructive adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol. 2014;78:1449–51.CrossRef Onder S, Caypinar B, Sahin-Yilmaz A, Toros SZ, Oysu C. Relation of mean platelet volume with obstructive adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol. 2014;78:1449–51.CrossRef
25.
go back to reference Soyalıç H, Somuk BT, Doğru S, Gürbüzler L, Göktaş G, Eyibilen A. Evaluation of mean platelet volume and its ratio over platelet count in children with obstructive sleep apnea syndrome. Kulak Burun Bogaz Ihtis Derg. 2015;25:16–21.CrossRef Soyalıç H, Somuk BT, Doğru S, Gürbüzler L, Göktaş G, Eyibilen A. Evaluation of mean platelet volume and its ratio over platelet count in children with obstructive sleep apnea syndrome. Kulak Burun Bogaz Ihtis Derg. 2015;25:16–21.CrossRef
26.
go back to reference Simsek G, Karacayli C, Ozel A, Arslan B, Muluk NB, Kilic R. Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy. J Craniofac Surg. 2015;26:213–6.CrossRef Simsek G, Karacayli C, Ozel A, Arslan B, Muluk NB, Kilic R. Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy. J Craniofac Surg. 2015;26:213–6.CrossRef
27.
go back to reference Zicari AM, Occasi F, Di Mauro F, Lollobrigida V, Di Fraia M, Savastano V, Loffredo L, Nicita F, Spalice A, Duse M. Mean platelet volume, vitamin D and C reactive protein levels in normal weight children with primary snoring and obstructive sleep apnea syndrome. PLoS One. 2016;11:0152497.CrossRef Zicari AM, Occasi F, Di Mauro F, Lollobrigida V, Di Fraia M, Savastano V, Loffredo L, Nicita F, Spalice A, Duse M. Mean platelet volume, vitamin D and C reactive protein levels in normal weight children with primary snoring and obstructive sleep apnea syndrome. PLoS One. 2016;11:0152497.CrossRef
28.
go back to reference Erdim I, Erdur O, Oghan F, Mete F, Celik M. Blood count values and ratios for predicting sleep apnea in obese children. Int J Pediatr Otorhinolaryngol. 2017;98:85–90.CrossRef Erdim I, Erdur O, Oghan F, Mete F, Celik M. Blood count values and ratios for predicting sleep apnea in obese children. Int J Pediatr Otorhinolaryngol. 2017;98:85–90.CrossRef
29.
go back to reference Barceló A, Morell-Garcia D, Sanchís P, Peña-Zarza JA, Bauça JM, Piérola J, de la Peña M, Toledo-Pons N, Giménez P, Ribot C, Alonso-Fernández A. Prothrombotic state in children with obstructive sleep apnea. Sleep Med. 2019;53:101–5.CrossRef Barceló A, Morell-Garcia D, Sanchís P, Peña-Zarza JA, Bauça JM, Piérola J, de la Peña M, Toledo-Pons N, Giménez P, Ribot C, Alonso-Fernández A. Prothrombotic state in children with obstructive sleep apnea. Sleep Med. 2019;53:101–5.CrossRef
30.
go back to reference Horne RS, Wijayaratne P, Nixon GM, Walter LM. Sleep and sleep disordered breathing in children with Down syndrome: effects on behaviour, neurocognition and the cardiovascular system. Sleep Med Rev. 2019;44:1–11.CrossRef Horne RS, Wijayaratne P, Nixon GM, Walter LM. Sleep and sleep disordered breathing in children with Down syndrome: effects on behaviour, neurocognition and the cardiovascular system. Sleep Med Rev. 2019;44:1–11.CrossRef
31.
go back to reference Shen L, Lin Z, Lin X, Yang Z. Risk factors associated with obstructive sleep apnea-hypopnea syndrome in Chinese children: a single center retrospective case-control study. PLoS One. 2018;13:0203695. Shen L, Lin Z, Lin X, Yang Z. Risk factors associated with obstructive sleep apnea-hypopnea syndrome in Chinese children: a single center retrospective case-control study. PLoS One. 2018;13:0203695.
32.
go back to reference Stone RS, Spiegel JH. Prevalence of obstructive sleep disturbance in children with failure to thrive. J Otolaryngol Head Neck Surg. 2009;38:573–9.PubMed Stone RS, Spiegel JH. Prevalence of obstructive sleep disturbance in children with failure to thrive. J Otolaryngol Head Neck Surg. 2009;38:573–9.PubMed
33.
go back to reference Hill CM, Hogan AM, Onugha N, Harrison D, Cooper S, McGrigor VJ, Datta A, Kirkham FJ. Increased cerebral blood flow velocity in children with mild sleep-disordered breathing: a possible association with abnormal neuropsychological function. Pediatrics. 2006;118:1100–8.CrossRef Hill CM, Hogan AM, Onugha N, Harrison D, Cooper S, McGrigor VJ, Datta A, Kirkham FJ. Increased cerebral blood flow velocity in children with mild sleep-disordered breathing: a possible association with abnormal neuropsychological function. Pediatrics. 2006;118:1100–8.CrossRef
34.
go back to reference Chang CH, Chen SJ, Liu CY. Pediatric sleep apnea and depressive disorders risk: a population-based 15-year retrospective cohort study. PLoS One. 2017;12:0181430. Chang CH, Chen SJ, Liu CY. Pediatric sleep apnea and depressive disorders risk: a population-based 15-year retrospective cohort study. PLoS One. 2017;12:0181430.
35.
go back to reference Kim DY, Ko KO, Lim JW, Yoon JM, Song YH, Cheon EJ. The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea. Korean J Pediatr. 2018;61:392–6.CrossRef Kim DY, Ko KO, Lim JW, Yoon JM, Song YH, Cheon EJ. The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea. Korean J Pediatr. 2018;61:392–6.CrossRef
36.
go back to reference Tan HL, Gozal D, Kheirandish-Gozal L. Obstructive sleep apnea in children: a critical update. Nat Sci Sleep. 2013;5:109–23.PubMedPubMedCentral Tan HL, Gozal D, Kheirandish-Gozal L. Obstructive sleep apnea in children: a critical update. Nat Sci Sleep. 2013;5:109–23.PubMedPubMedCentral
37.
go back to reference Kheirandish-Gozal L. The endothelium as a target in pediatric OSA. Front Neurol. 2012;3:92.CrossRef Kheirandish-Gozal L. The endothelium as a target in pediatric OSA. Front Neurol. 2012;3:92.CrossRef
38.
go back to reference Zou S, Teixeira AM, Kostadima M, Astle WJ, Radhakrishnan A, Simon LM, Truman L, Fang JS, Hwa J, Zhang PX, van der Harst P, Bray PF, Ouwehand WH, Frontini M, Krause DS. SNP in human ARHGEF3 promoter is associated with DNase hypersensitivity, transcript level and platelet function, and Arhgef3 KO mice have increased mean platelet volume. PLoS One. 2017;12:0178095. Zou S, Teixeira AM, Kostadima M, Astle WJ, Radhakrishnan A, Simon LM, Truman L, Fang JS, Hwa J, Zhang PX, van der Harst P, Bray PF, Ouwehand WH, Frontini M, Krause DS. SNP in human ARHGEF3 promoter is associated with DNase hypersensitivity, transcript level and platelet function, and Arhgef3 KO mice have increased mean platelet volume. PLoS One. 2017;12:0178095.
Metadata
Title
Mean platelet volume levels in children with sleep-disordered breathing: a meta-analysis
Authors
Wen-Dien Chang
Chih-Hao Tseng
Yung-An Tsou
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Snoring
Published in
BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-020-02099-5

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