Relationship between plasma homocysteine and obstructive sleep apneas in children: a preliminary study

Introduction: Plasma homocysteine concentration is increased adult patients with obstructive sleep apneas, whilst it is still unknown if its plasma levels may also be enhanced in obstructive sleep apnea in childhood. We investigated the possible relationship between plasma homocysteine and obstructive sleep apnea in children. Methods: A total number of 199 children were studied between July 2016 and June 2017. All children underwent an overnight respiratory polygraph study. Laboratory data were retrospectively reviewed, inclusing plasma homocysteine, folate and vitamin B12. Statistical analysis was performed using SPSS Statistics 22.0® software. Results: Twenty children were finally included in our study. Linear regression analysis showed that plasma homocysteine was positively correlated with age (β=2.930; p=0.010), and inversely correlated with folate (β=-4.830; p<0.001), vitamin B12 (β=-3.844; p=0.002) and haemoglobin (β=-3.503; p=0.003). No significant correlation was found with platelet count (p=0.578) and apnea-hypopnea index (p=0.272). After age adjustment, homocysteine levels remained inversely correlated with folate, but no association was found with sleep respiratory parameters. Conclusion: This retrospective study suggests that serum homocysteine levels is not increased in children with obstructive sleep apnea, whilst, a folate-enriched diet seems advisable in children with obstructive sleep apnea to counteract oxidative stress. Further controlled studies are needed.