{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:52:10Z","timestamp":1791420730785,"version":"4.3.3"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adenotonsillar hypertrophy (ATH) is the leading cause of obstructive sleep apnea (OSA) in children. While the role of allergic inflammation (IgE-mediated) has been widely studied, the contribution of mucosal immunity\u2014specifically Immunoglobulin A (IgA)\u2014to disease severity remains unclear. This study aimed to investigate the association between serum immune markers and OSA severity and to construct a multivariate diagnostic model for moderate-to-severe disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 110 children diagnosed with ATH were enrolled in this cross-sectional study. Based on polysomnography (PSG) results and the\n                      <jats:italic>2020 Chinese Guidelines for Diagnosis and Treatment of Childhood OSA<\/jats:italic>\n                      , participants were divided into a Mild\/No OSA group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200965) and a Moderate-to-Severe OSA group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945). Serum immunoglobulins (IgA, IgE, IgG, IgM) and complement components (C3c, C4) were analyzed. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Moderate-to-Severe group exhibited significantly lower lowest oxygen saturation (LSpO2) [0.85 (0.81, 0.89) vs. 0.89 (0.86, 0.91),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001], larger adenoids [A\/N ratio: 0.77 (0.71, 0.80) vs. 0.65 (0.62, 0.75),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001], and a higher proportion of Grade III tonsils (28.9% vs. 12.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Notably, serum IgA levels were significantly elevated in the Moderate-to-Severe group (2.05\u2009\u00b1\u20090.55 vs. 1.79\u2009\u00b1\u20090.75\u2005g\/L,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032), while IgE showed no significant difference. Multivariate logistic regression identified LSpO2 (OR\u2009=\u20090.853,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) as a protective factor, while Tonsillar Hypertrophy (ORs 27.09\u201345.54) and IgA (OR\u2009=\u20092.520, 95% CI: 1.033\u20136.146,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.042) were independent risk factors. A combined model incorporating these variables achieved an Area Under the Curve (AUC) of 0.852.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated serum IgA is an independent associated factor of moderate-to-severe OSA in children with ATH, suggesting a potential mechanism involving chronic mucosal inflammation distinct from atopy. A combined diagnostic model involving IgA, anatomical metrics, and oximetry provides high diagnostic value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1791876","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:50:58Z","timestamp":1778219458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Independent association of serum IgA levels with moderate-to-severe obstructive sleep apnea in children with adenotonsillar hypertrophy"],"prefix":"10.3389","volume":"14","author":[{"given":"Fei","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology","place":["Wuhan, Hubei, 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