Relationship of Potential İnflammatory Markers Namely Neutrophile Lymphocyte Ratio and Platelet Lymphocyte Ratio with The Severity of Obstructive Sleep Apnea

Oğuz Dikbaş, Nilgün Erten, Fatma Küçüker, Özge Yılmaz Akşehirli

Öz


Aim: The aim of the present study is to evaluate hematological parameters in patients with obstructive sleep apnea syndrome (OSAS).
Material and Methods: Patients underwent a polysomnographic (PSG) test at our sleep laboratory was retrospectively reviewed.
Patients with cancer, cardiovascular disease, hematologic disorders, infectious diseases and rheumatologically disorders, renal or
hepatic insufficiency were excluded from the study. Two hundred and ten OSAS patients with an apnea-hypopnea index (AHI) of more
than five events and 57 controls with an AHI of less than four events were included. Study population was divided into four groups
depending on the AHI as: mild OSAS (AHI= 5-15), moderate OSAS (AHI=15-30), severe OSAS (AHI>30), and the control (AHI<5).
Hematologic parameters were measured and compared.
Results: Platelet lymphocyte ratio was significantly lower in patients with OSAS compared to the control (p = 0.050). Neutrophil
lymphocyte ratio between OSAS and the control was not different (p = 0.947). Serum triglyceride level and mean platelet volume were
significantly higher in patients with OSAS (p < 0.0001; p = 0.043). Platelet distribution width was significantly higher in severe OSAS
group compared to control, mild and moderate OSAS subgroups (0.014).
Conclusion: No relationship was found between OSAS and NLR. There is a debate over putative relationship between NLR, PLR, and
OSAS.

Anahtar Kelimeler


Obstructive sleep apnea syndrome, OSAS, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio

Tam Metin:

PDF

Referanslar


References:

Gharibeh T, Mehra R. Obstructive sleep apnea syndrome: natural history, diagnosis, and emerging treatment options. Nature and science of sleep. 2010;2:233-55. PubMed PMID: 23616712. Pubmed Central PMCID: PMC3630950. Epub 2010/01/01. eng.

Azagra-Calero E, Espinar-Escalona E, Barrera-Mora JM, Llamas-Carreras JM, Solano-Reina E. Obstructive sleep apnea syndrome (OSAS). Review of the literature. Medicina oral, patologia oral y cirugia bucal. 2012 Nov;17(6):e925-9. PubMed PMID: 22549673. Pubmed Central PMCID: PMC3505711. Epub 2012/05/03. eng.

Maspero C, Giannini L, Galbiati G, Rosso G, Farronato G. Obstructive sleep apnea syndrome: a literature review. Minerva stomatologica. 2015 Apr;64(2):97-109. PubMed PMID: 25747430. Epub 2015/03/10. eng

ita.

Munoz R, Duran-Cantolla J, Martinez-Vila E, Gallego J, Rubio R, Aizpuru F, et al. Severe sleep apnea and risk of ischemic stroke in the elderly. Stroke; a journal of cerebral circulation. 2006 Sep;37(9):2317-21. PubMed PMID: 16888274. Epub 2006/08/05. eng.

Partinen M. Epidemiology of obstructive sleep apnea syndrome. Current opinion in pulmonary medicine. 1995 Nov;1(6):482-7. PubMed PMID: 9363086. Epub 1995/11/01. eng.

Botros N, Concato J, Mohsenin V, Selim B, Doctor K, Yaggi HK. Obstructive sleep apnea as a risk factor for type 2 diabetes. The American journal of medicine. 2009 Dec;122(12):1122-7. PubMed PMID: 19958890. Pubmed Central PMCID: PMC2799991. Epub 2009/12/05. eng.

Chen L, Pei JH, Chen HM. Effects of continuous positive airway pressure treatment on glycaemic control and insulin sensitivity in patients with obstructive sleep apnoea and type 2 diabetes: a meta-analysis. Archives of medical science : AMS. 2014 Aug 29;10(4):637-42. PubMed PMID: 25276145. Pubmed Central PMCID: PMC4175764. Epub 2014/10/03. eng.

Destors M, Tamisier R, Baguet JP, Levy P, Pepin JL. [Cardiovascular morbidity associated with obstructive sleep apnea syndrome]. Revue des maladies respiratoires. 2014 Apr;31(4):375-85. PubMed PMID: 24750957. Epub 2014/04/23. Morbidite cardiovasculaire associee au syndrome d'apnee obstructive du sommeil. fre.

Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O'Connor GT, Resnick HE, et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. American journal of respiratory and critical care medicine. 2010 Jul 15;182(2):269-77. PubMed PMID: 20339144. Pubmed Central PMCID: PMC2913239. Epub 2010/03/27. eng.

Ryan S, Taylor CT, McNicholas WT. Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome? Postgraduate medical journal. 2009 Dec;85(1010):693-8. PubMed PMID: 20075410. Epub 2010/01/16. eng.

Zamarron C, Valdes Cuadrado L, Alvarez-Sala R. Pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome. Pulmonary medicine. 2013;2013:521087. PubMed PMID: 23936649. Pubmed Central PMCID: PMC3712227. Epub 2013/08/13. eng.

Castro-Anon O, Perez de Llano LA, De la Fuente Sanchez S, Golpe R, Mendez Marote L, Castro-Castro J, et al. Obesity-hypoventilation syndrome: increased risk of death over sleep apnea syndrome. PloS one. 2015;10(2):e0117808. PubMed PMID: 25671545. Pubmed Central PMCID: PMC4324970. Epub 2015/02/12. eng.

Ucar ZZ, Cirak AK, Olcay S, Uysal H, Demir AU, Ozacar R. Association of duration of sleep and cardiovascular and metabolic comorbidities in sleep apnea syndrome. Sleep disorders. 2012;2012:316232. PubMed PMID: 23471129. Pubmed Central PMCID: PMC3581129. Epub 2012/01/01. eng.

Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 1996 Mar;7(2):157-61. PubMed PMID: 8735807. Epub 1996/03/01. eng.

Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogeneity. Blood. 1988 Jul;72(1):1-8. PubMed PMID: 3291975. Epub 1988/07/01. eng.

Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. The American journal of cardiology. 2010 Jan 15;105(2):186-91. PubMed PMID: 20102916. Epub 2010/01/28. eng.

Nilsson L, Wieringa WG, Pundziute G, Gjerde M, Engvall J, Swahn E, et al. Neutrophil/Lymphocyte ratio is associated with non-calcified plaque burden in patients with coronary artery disease. PloS one. 2014;9(9):e108183. PubMed PMID: 25268632. Pubmed Central PMCID: PMC4182451. Epub 2014/10/01. eng.

Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavske lekarske listy. 2001;102(1):5-14. PubMed PMID: 11723675. Epub 2001/11/29. eng

slo.

Azab B, Shah N, Akerman M, McGinn JT, Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. Journal of thrombosis and thrombolysis. 2012 Oct;34(3):326-34. PubMed PMID: 22466812. Epub 2012/04/03. eng.

Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PloS one. 2013;8(7):e67688. PubMed PMID: 23844064. Pubmed Central PMCID: PMC3699634. Epub 2013/07/12. eng.

Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. Journal of thrombosis and thrombolysis. 2015 Feb;39(2):179-85. PubMed PMID: 25002338. Epub 2014/07/09. eng.

Yenigun A, Karamanli H. Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome. The Journal of laryngology and otology. 2015 Sep;129(9):887-92. PubMed PMID: 26235249. Epub 2015/08/04. eng.

Yasar Z, Buyuksirin M, Ucsular FD, Kargi A, Erdem F, Talay F, et al. Is an elevated neutrophil-to-lymphocyte ratio a predictor of metabolic syndrome in patients with chronic obstructive pulmonary disease? European review for medical and pharmacological sciences. 2015;19(6):956-62. PubMed PMID: 25855919. Epub 2015/04/10. eng.

Christoffersson G, Vagesjo E, Pettersson US, Massena S, Nilsson EK, Broman JE, et al. Acute sleep deprivation in healthy young men: impact on population diversity and function of circulating neutrophils. Brain, behavior, and immunity. 2014 Oct;41:162-72. PubMed PMID: 24878171. Epub 2014/06/01. eng.

Boudjeltia KZ, Faraut B, Stenuit P, Esposito MJ, Dyzma M, Brohee D, et al. Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: a pilot study. Vascular health and risk management. 2008;4(6):1467-70. PubMed PMID: 19337560. Pubmed Central PMCID: PMC2663438. Epub 2008/01/01. eng.

Barcelo A, Pierola J, de la Pena M, Esquinas C, Fuster A, Sanchez-de-la-Torre M, et al. Free fatty acids and the metabolic syndrome in patients with obstructive sleep apnoea. The European respiratory journal. 2011 Jun;37(6):1418-23. PubMed PMID: 21177837. Epub 2010/12/24. eng.

Xu H, Yi H, Guan J, Yin S. Effect of continuous positive airway pressure on lipid profile in patients with obstructive sleep apnea syndrome: a meta-analysis of randomized controlled trials. Atherosclerosis. 2014 Jun;234(2):446-53. PubMed PMID: 24769714. Epub 2014/04/29. eng.

Li J, Zhang Y, Wang J, Feng P, Chen R, Cao Y, et al. [Association between serum lipoprotein lipase level and dyslipidemia in patients with obstructive sleep apnea syndrome]. Zhonghua yi xue za zhi. 2014 Feb 18;94(6):403-7. PubMed PMID: 24754980. Epub 2014/04/24. chi.

Chou YT, Chuang LP, Li HY, Fu JY, Lin SW, Yang CT, et al. Hyperlipidaemia in patients with sleep-related breathing disorders: prevalence & risk factors. The Indian journal of medical research. 2010 Feb;131:121-5. PubMed PMID: 20308737. Epub 2010/03/24. eng.

Parish JM, Adam T, Facchiano L. Relationship of metabolic syndrome and obstructive sleep apnea. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2007 Aug 15;3(5):467-72. PubMed PMID: 17803009. Pubmed Central PMCID: PMC1978322. Epub 2007/09/07. eng.

Li J, Thorne LN, Punjabi NM, Sun CK, Schwartz AR, Smith PL, et al. Intermittent hypoxia induces hyperlipidemia in lean mice. Circulation research. 2005 Sep 30;97(7):698-706. PubMed PMID: 16123334. Epub 2005/08/27. eng.

Gunbatar H, Sertogullarindan B, Ekin S, Akdag S, Arisoy A, Sayhan H. The correlation between red blood cell distribution width levels with the severity of obstructive sleep apnea and carotid intima media thickness. Medical science monitor : international medical journal of experimental and clinical research. 2014;20:2199-204. PubMed PMID: 25380170. Pubmed Central PMCID: PMC4301218. Epub 2014/11/08. eng.

Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2003 Jul;9(3):177-90. PubMed PMID: 14507105. Epub 2003/09/26. eng.

Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. Journal of thrombosis and thrombolysis. 2006 Dec;22(3):161-4. PubMed PMID: 17111202. Epub 2006/11/18. eng.

Kurt OK, Yildiz N. The importance of laboratory parameters in patients with obstructive sleep apnea syndrome. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2013 Jun;24(4):371-4. PubMed PMID: 23322273. Epub 2013/01/17. eng.

Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010 Jan;14(1):28-32. PubMed PMID: 20411056. Pubmed Central PMCID: PMC2843567. Epub 2010/04/23. eng.


Refback'ler

  • Şu halde refbacks yoktur.