Research on Large Endothelial Cell-Derived Extracellular Vesicles in Pediatric Obstructive Sleep Apnea Syndrome.

PURPOSE: To explore the association between clinical indicators of obstructive sleep apnea (OSA) and large endothelial cell-derived extracellular vesicles (large endothelial EVs) in children, and to explore their potential association with disease severity.

PATIENTS AND

METHODS

A total of 81 children with OSA were enrolled, including 29 cases of mild OSA and 52 cases of moderate-to-severe OSA. Receiver operating characteristic (ROC) curves evaluated the discriminatory ability of these EVs for severity groups. The correlation between large endothelial EVs and OSA clinical results, including sleep architecture and sleep-disordered breathing events, was evaluated using Spearman correlation analysis and multiple regression analysis.

RESULTS

Levels of CD31+CD41- large endothelial EVs were significantly elevated in children with moderate-to-severe OSA compared to the mild OSA group (p< 0.05). While CD62E levels were nominally elevated in moderate-to-severe OSA (p<0.05), this association did not persist following false discovery rate correction, and the marker showed limited predictive utility in the validation cohort (AUC = 0.538). The ROC curve results indicated that the sensitivity and specificity of CD31+CD41- in distinguishing mild OSA from moderate-to-severe OSA were 82.8% and 75%, respectively, with an area under the curve of 0.848. CD31+CD41- large endothelial EVs in children with OSA showed significant positive correlations with the Obstructive Apnea-Hypopnea Index (OAHI), hypopnea index, and oxygen desaturation index (p<0.05). Multiple regression analysis revealed a logarithmic positive correlation between OAHI and CD31+CD41- large endothelial EVs (p<0.01). Sleep efficiency was negatively correlated with CD31+CD41- large endothelial EVs (p<0.05).

CONCLUSION

CD31+CD41- large endothelial EVs were closely associated with OAHI and sleep efficiency. These exploratory findings suggest their potential as a biomarker of OSA severity, but prospective validation is required before clinical application.