PROTEOMIC SIGNATURES OF INFLAMMATION AND CARDIOVASCULAR RISK IN PEDIATRIC OBSTRUCTIVE SLEEP APNEA (OSA)

Pediatric obstructive sleep apnea (OSA) is associated with inflammation and cardiovascular (CV) risk, although biomarkers for early risk stratification are scarce. To characterise children with OSA by exploring inflammatory and CV protein profiles. Serum samples from 88 children in the Kids Trial cohort were analysed: 35 controls with an obstructive apnoea-hypopnoea index (OAHI) <3/h and 53 with moderate/severe OSA (OAHI ≥5/h). Proteomic analysis included volcano plots combining fold change with p-values and false discovery rate (FDR)-adjusted values. Sparse Partial Least Squares Discriminant Analysis (sPLS-DA) was performed. ROC analysis was used to assess the classification performance of the proteins, along with the AUC, sensitivity, specificity, and optimal cut-off values. Of the 272 analysed proteins, 51 were found to be differentially expressed, with 3 remaining significant after correction for FDR (Fig. 1). sPLS-DA revealed partial separation between OSA group and controls. IL-1Ra contributed most to the separation between groups (Fig. 2). AUC analysis identified the top 5 proteins that best discriminated between the groups. Gal-9 showed good discriminatory ability between OSA and controls (AUC = 0.84, Fig. 3). Children with OSA exhibit increased inflammatory and CV protein profiles compared to controls. Gal-9 may represent a valuable biomarker for identifying children with OSA, with implications for diagnosis and clinical management.