To the best of our knowledge, this is a first meta-analysis on this field of pediatrics. This meta-analysis evaluates the relationship of pediatric SDB and MPV by combining data from all the relevant articles. There are very few reports that show the correlation of MVP in patients with pediatric SDB, and relationship of increase of MVP and pediatric SDB was still unclear. It is reported that adult patients with sleep-disordered breathing have higher MPV, and MPV disease after wearing continuous positive airway pressure, and sleep surgery by uvulopalatal flap in adult patients with sleep-disordered breathing. Some studies have shown a significant association between MPV and sleep-disordered breathing in adult patients. A recent study have evaluated MPV in adult patients with sleep-disordered breathing. MPV is also associated with increase in catabolic metabolic status, as well as arterial and venous thrombosis. MPV was associated with the factors of cardiovascular disease risk, like diabetes, hypertension, systemic lupus erythematosus, and atherosclerosis. Mean platelet volume (MPV) is an inexpensive and simple test, using to measure platelet size, and is a platelet activity marker. Platelet volume correlated with cardiovascular disease, and coronary heart disease. The association of pediatric SDB caused to increase interest in its role in upper respiratory tract infection, and pediatric hypertension, failure to thrive (increased catabolic status by chronic inflammation), and attention deficiency disorders. Pediatric sleep apnea is defined as AHI > 1 per hour or hypercapnia (PaCO2 > 50 mmHg) in 25% sleep time association with snoring, paradoxical thoracoabdominal motion etc. Pediatric SDB needed to be diagnosis if pediatric patients with night time symptoms of snoring or obstructed breathing during sleep daytime symptoms such as excessive daytime sleepiness and associated neuropsychiatric problems as behavioral problems agitation behavior, poor concentration, and other problems concerning to grow retardation or learning difficulties. The pediatric SDB is correlated with pediatric upper respiratory tract infection, failure to thrive, pediatric hypertension, and attention deficiency. Pediatric sleep-disordered breathing (SDB) is characterized by loud snoring and or hypopnea at night and is associated with upper airway infections, attention disorder, and failure to thrive. The level of MPV could be reduced by the two surgeries, especially adenotonsillectomy. The MPV was significantly higher in patients with pediatric SDB, indicating the presence of increased platelet activity in pediatric SDB patients. 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). 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). 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). 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). There were seven studies included in the review. 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. MethodsĪ 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. 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. Increase of MPV level may cause failure to thrive or increased upper airway infection rate. Mean platelet volume (MPV) was an inflammatory marker, related to increased inflammatory condition of pediatric patients. Pediatric sleep-disordered breathing (SDB) correlated with respiratory conditions of snoring and hypopnea.
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