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New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio

Year 2021, Volume: 10 Issue: 1, 32 - 39, 30.04.2021
https://doi.org/10.47493/abantmedj.2021.30

Abstract

Purpose: The aim of this study is to analyze correlation between novel markers mean platelet volume (MPV)/high density lipoprotein (HDL) and erythrocyte diameter width (RDW)/HDL ratios, and existence and severity of OSAS.
Methods: Patients who had polysomnography test between January 2017 to March 2020 were evaluated and 510 patients whose complete records could be obtained were enrolled. Participants who were using drugs affecting thyroid and sleep order were excluded. Participants were compared for age, gender, monocyte, neutrophil, lymphocyte and platelet counts, mean corpuscular volume (MCV), MPV, RDW, HDL, monocyte/HDL, MPV/HDL and RDW/HDL ratios in OSAS group and control group.
Results: There was a significant correlation between severity of OSAS and age, HDL, RDW, MPV/HDL and RDW/HDL ratios. Compared to control group, there were significant differences in age (p=0.005) and HDL (p=0.001) in OSAS group.
Conclusion: MPV/HDL and RDW/HDL ratios may be used to predict severity of OSAS, as novel markers.

Thanks

Authors wish to thank sleep laboratory personnel for their kind help in gathering patient information, Mr. Fatih Acikgoz for his help in statistical analysis and Dr. Dogan ATAN for evaluation of polysomnography results.

References

  • 1. Attal P, Chanson P. (2010). Endocrine Aspects of Obstructive Sleep Apnea. The Journal of Clinical Endocrinology & Metabolism, 95(2), 483–495. doi:10.1210/jc.2009-1912.
  • 2. Thorpy M. (2017). International Classification of Sleep Disorders. Sleep Disorders Medicine, 475–484. doi:10.1007/978-1-4939-6578-6_27.
  • 3. Xie JY1, Liu WX, Ji L, Chen Z, Gao JM, Chen W, Chen GF, Zhu Q. Relationship between inflammatory factors and arrhythmia and heart rate variability in OSAS patients. Eur Rev Med Pharmacol Sci. 2020 Feb;24(4):2037-2053. doi: 10.26355/eurrev_202002_20382.
  • 4. Ozsu S, Abul Y, Gulsoy A, Bulbul Y, Yaman S, Ozlu T. (2012). Red Cell Distribution Width in Patients with Obstructive Sleep Apnea Syndrome. Lung, 190(3), 319–326. doi:10.1007/s00408-012-9376-x.
  • 5. Davi G, Patrono C. (2007). Platelet Activation and Atherothrombosis. New England Journal of Medicine, 357(24), 2482–2494. doi:10.1056/nejmra071014.
  • 6. Park Y, Schoene N, Harris W. (2002). Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets, 13(5-6), 301–306. doi:10.1080/095371002220148332.
  • 7. Giles H, Smith RE, Martin JF. (1994). Platelet glycoprotein IIb-IIIa and size are increased in acute myocardial infarction. European Journal of Clinical Investigation, 24(1), 69–72. doi:10.1111/j.1365-2362.1994.tb02062.x.
  • 8. Nena E, Papanas N, Steiropoulos P, Zikidou P, Zarogoulidis P, Pita E, Constantinidis TC, Maltezos E, Mikhailidis DP, Bouros D. (2011). Mean Platelet Volume and Platelet Distribution Width in non-diabetic subjects with Obstructive Sleep Apnoea Syndrome: New indices of severity? Platelets, 23(6), 447–454. doi:10.3109/09537104.2011.632031.
  • 9. Vazzana N, Ganci A, Cefalu AB, Lattanzio S, Noto D, Santoro N, Saggini R, Puccetti L, Averna M, Davi G. (2013). Enhanced Lipid Peroxidation and Platelet Activation as Potential Contributors to Increased Cardiovascular Risk in the Low‐HDL Phenotype. Journal of the American Heart Association, 2(2). doi:10.1161/jaha.113.000063.
  • 10. Podrez EA. (2010). Anti-oxidant properties of high-density lipoprotein and atherosclerosis. Clinical and Experimental Pharmacology and Physiology, 37(7), 719–725. doi:10.1111/j.1440-1681.2010.05380.x.
  • 11. Avci E, Kiris T, Demirtas AO, Kadi H. (2018). Relationship between high-density lipoprotein cholesterol and the red cell distribution width in patients with coronary artery disease. Lipids in Health and Disease, 17(1). doi:10.1186/s12944-018-0709-5.
  • 12. Varol E, Aksoy F, Bas HA, Ari H, Ozaydin M. (2013). Mean Platelet Volume is Elevated in Patients With Low High-Density Lipoprotein Cholesterol. Angiology, 65(8), 733–736. doi:10.1177/0003319713504024.
  • 13. Ursavas A, Karadag M, Rodoplu E, Yilmaztepe A, Oral HB, Gozu RO. Circulating ICAM-1 and VCAM-1 Levels in Patients With Obstructive Sleep Apnea Syndrome. Respiration. 2007;74(5):525-32. doi: 10.1159/000097770.
  • 14. Planellas M, Cuenca R, Tabar MD, Bertolani C, Poncet C, Closa JM, Lorente J, Ceron JJ, Pastor J. (2015). Clinical assessment and C-reactive protein (CRP), haptoglobin (Hp), and cardiac troponin I (cTnI) values of brachycephalic dogs with upper airway obstruction before and after surgery. Canadian Journal of Veterinary Research = Revue Canadienne De Recherche Veterinaire, 79(1), 58–63.
  • 15. Nizam N, Basoglu OK, Tasbakan MS, Lappin DF, Buduneli N. (2015). Is there an association between obstructive sleep apnea syndrome and periodontal inflammation? Clinical Oral Investigations, 20(4), 659–668. doi:10.1007/s00784-015-1544-y.
  • 16. Yokoe T, Minoguchi K, Matsuo H, Oda, N, Minoguchi H, Yoshino G, Hirano T, Adachi M. (2003). Elevated Levels of C-Reactive Protein and Interleukin-6 in Patients With Obstructive Sleep Apnea Syndrome Are Decreased by Nasal Continuous Positive Airway Pressure. Circulation, 107(8), 1129–1134. doi:10.1161/01.cir.0000052627.99976.18.
  • 17. Lippi G, Sanchis-Gomar F, Danese E, Montagnana M. (2013). Association of red blood cell distribution width with plasma lipids in a general population of unselected outpatients. Kardiologia Polska, 931–936. doi:10.5603/kp.2013.0228.
  • 18. Gasparyan A, Ayvazyan L, Mikhailidis D, Kitas G. (2011). Mean Platelet Volume: A Link Between Thrombosis and Inflammation? Current Pharmaceutical Design, 17(1), 47–58. doi:10.2174/138161211795049804.
  • 19. Varol E, Aksoy F, Ozaydin M, Erdogan D, Dogan A. (2014). Association between neutrophil–lymphocyte ratio and mitral annular calcification. Blood Coagulation & Fibrinolysis, 25(6), 557–560. doi:10.1097/mbc.0000000000000094.
  • 20. Battinelli E, Willoughby SR, Foxall T, Valeri CR, Loscalzo J. (2001). Induction of platelet formation from megakaryocytoid cells by nitric oxide. Proceedings of the National Academy of Sciences, 98(25), 14458–14463. doi:10.1073/pnas.241427398.
  • 21. Wu, M., Zhou, L., Zhu, D., Lai, T., Chen, Z., & Shen, H. (2018). Hematological indices as simple, inexpensive and practical severity markers of obstructive sleep apnea syndrome: a meta-analysis. Journal of Thoracic Disease, 10(12), 6509–6521. doi:10.21037/jtd.2018.10.105.
  • 22. Dunleavy M, Dooley M, Cox D, Bradford A. (2005). Chronic intermittent asphyxia increases platelet reactivity in rats. Experimental Physiology, 90(3), 411–416.
  • 23. Rahangdale S, Yeh SY, Novack V, Stevenson K, Barnard MR, Furman MI, Frelinger AL, Michelson AD, Malhotra A. (2011). The Influence of Intermittent Hypoxemia on Platelet Activation in Obese Patients with Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, 07(02), 172–178. doi:10.5664/jcsm.28105.
  • 24. Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, Chaves PA, Ershler WB, Longo DL. (2005). Proinflammatory state and circulating erythropoietin in persons with and without anemia. The American Journal of Medicine, 118(11), 1288.e11–1288.e19. doi:10.1016/j.amjmed.2005.06.039.
  • 25. Jennum P, Riha RL. (2009). Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. European Respiratory Journal, 33(4), 907–914. doi:10.1183/09031936.00180108.
  • 26. Huang KT, Chin CH, Tseng CC, Chang HC, Chen YC, Wang CC, Lin MC, Lin HC, Su MC. (2014). The Influence of Obesity on Different Genders in Patients with Obstructive Sleep Apnea. The Scientific World Journal, 2014, 1–8. doi:10.1155/2014/487215.

Obstrüktif Uyku Apne Sendromu Şiddetini Gösteren Kolay ve Pratik Yeni Belirteçler: Ortalama Trombosit Hacmi/Yüksek Dansiteli Lipoprotein ve Eritrosit Dağılım Hacmi/Yüksek Dansiteli Lipoprotein

Year 2021, Volume: 10 Issue: 1, 32 - 39, 30.04.2021
https://doi.org/10.47493/abantmedj.2021.30

Abstract

Amaç: Bu çalışmanın amacı, yeni birer belirteç olan; ortalama trombosit hacmi (MPV)/yüksek dansiteli lipoprotein (HDL) ve eritrosit dağılım hacmi (RDW)/HDL oranları ile obstrüktif uyku apne sendromu (OUAS) varlığı ve şiddeti arasındaki ilişkiyi değerlendirmektir.
Gereç ve Yöntem: Ocak 2017 ile Mart 2020 arasında polisomnografi yapılan ve sonuçlarına eksiksiz ulaşılabilen 510 hasta ile çalışma yapılmıştır. Tiroid hormon düzeylerini ve uyku düzenini etkileyebilecek ilaç kullanan hastalar çalışma dışı tutulmuştur. OUAS olan ve OUAS olmayan hastaların; yaş, cinsiyet, nötrofil, lenfosit ve trombosit sayısı, ortalama eritrosit hacmi (MCV), MPV, RDW, HDL, monosit/HDL, MPV/HDL ve RDW/HDL oranları karşılaştırıldı.
Bulgular: OUAS şiddetiyle; yaş, HDL, RDW, MPV/HDL ve RDW/HDL oranı arasında anlamlı bir ilişki saptanmıştır. OUAS olanlarda kontrol grubuna göre (OUAS olmayan); yaş ve cinsiyet arasında anlamlı bir ilişki saptanmıştır.
Sonuç: MPV/HDL ve RDW/HDL oranları, OUAS şiddetini göstermek için yeni birer belirteç olarak kullanılabilir.

References

  • 1. Attal P, Chanson P. (2010). Endocrine Aspects of Obstructive Sleep Apnea. The Journal of Clinical Endocrinology & Metabolism, 95(2), 483–495. doi:10.1210/jc.2009-1912.
  • 2. Thorpy M. (2017). International Classification of Sleep Disorders. Sleep Disorders Medicine, 475–484. doi:10.1007/978-1-4939-6578-6_27.
  • 3. Xie JY1, Liu WX, Ji L, Chen Z, Gao JM, Chen W, Chen GF, Zhu Q. Relationship between inflammatory factors and arrhythmia and heart rate variability in OSAS patients. Eur Rev Med Pharmacol Sci. 2020 Feb;24(4):2037-2053. doi: 10.26355/eurrev_202002_20382.
  • 4. Ozsu S, Abul Y, Gulsoy A, Bulbul Y, Yaman S, Ozlu T. (2012). Red Cell Distribution Width in Patients with Obstructive Sleep Apnea Syndrome. Lung, 190(3), 319–326. doi:10.1007/s00408-012-9376-x.
  • 5. Davi G, Patrono C. (2007). Platelet Activation and Atherothrombosis. New England Journal of Medicine, 357(24), 2482–2494. doi:10.1056/nejmra071014.
  • 6. Park Y, Schoene N, Harris W. (2002). Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets, 13(5-6), 301–306. doi:10.1080/095371002220148332.
  • 7. Giles H, Smith RE, Martin JF. (1994). Platelet glycoprotein IIb-IIIa and size are increased in acute myocardial infarction. European Journal of Clinical Investigation, 24(1), 69–72. doi:10.1111/j.1365-2362.1994.tb02062.x.
  • 8. Nena E, Papanas N, Steiropoulos P, Zikidou P, Zarogoulidis P, Pita E, Constantinidis TC, Maltezos E, Mikhailidis DP, Bouros D. (2011). Mean Platelet Volume and Platelet Distribution Width in non-diabetic subjects with Obstructive Sleep Apnoea Syndrome: New indices of severity? Platelets, 23(6), 447–454. doi:10.3109/09537104.2011.632031.
  • 9. Vazzana N, Ganci A, Cefalu AB, Lattanzio S, Noto D, Santoro N, Saggini R, Puccetti L, Averna M, Davi G. (2013). Enhanced Lipid Peroxidation and Platelet Activation as Potential Contributors to Increased Cardiovascular Risk in the Low‐HDL Phenotype. Journal of the American Heart Association, 2(2). doi:10.1161/jaha.113.000063.
  • 10. Podrez EA. (2010). Anti-oxidant properties of high-density lipoprotein and atherosclerosis. Clinical and Experimental Pharmacology and Physiology, 37(7), 719–725. doi:10.1111/j.1440-1681.2010.05380.x.
  • 11. Avci E, Kiris T, Demirtas AO, Kadi H. (2018). Relationship between high-density lipoprotein cholesterol and the red cell distribution width in patients with coronary artery disease. Lipids in Health and Disease, 17(1). doi:10.1186/s12944-018-0709-5.
  • 12. Varol E, Aksoy F, Bas HA, Ari H, Ozaydin M. (2013). Mean Platelet Volume is Elevated in Patients With Low High-Density Lipoprotein Cholesterol. Angiology, 65(8), 733–736. doi:10.1177/0003319713504024.
  • 13. Ursavas A, Karadag M, Rodoplu E, Yilmaztepe A, Oral HB, Gozu RO. Circulating ICAM-1 and VCAM-1 Levels in Patients With Obstructive Sleep Apnea Syndrome. Respiration. 2007;74(5):525-32. doi: 10.1159/000097770.
  • 14. Planellas M, Cuenca R, Tabar MD, Bertolani C, Poncet C, Closa JM, Lorente J, Ceron JJ, Pastor J. (2015). Clinical assessment and C-reactive protein (CRP), haptoglobin (Hp), and cardiac troponin I (cTnI) values of brachycephalic dogs with upper airway obstruction before and after surgery. Canadian Journal of Veterinary Research = Revue Canadienne De Recherche Veterinaire, 79(1), 58–63.
  • 15. Nizam N, Basoglu OK, Tasbakan MS, Lappin DF, Buduneli N. (2015). Is there an association between obstructive sleep apnea syndrome and periodontal inflammation? Clinical Oral Investigations, 20(4), 659–668. doi:10.1007/s00784-015-1544-y.
  • 16. Yokoe T, Minoguchi K, Matsuo H, Oda, N, Minoguchi H, Yoshino G, Hirano T, Adachi M. (2003). Elevated Levels of C-Reactive Protein and Interleukin-6 in Patients With Obstructive Sleep Apnea Syndrome Are Decreased by Nasal Continuous Positive Airway Pressure. Circulation, 107(8), 1129–1134. doi:10.1161/01.cir.0000052627.99976.18.
  • 17. Lippi G, Sanchis-Gomar F, Danese E, Montagnana M. (2013). Association of red blood cell distribution width with plasma lipids in a general population of unselected outpatients. Kardiologia Polska, 931–936. doi:10.5603/kp.2013.0228.
  • 18. Gasparyan A, Ayvazyan L, Mikhailidis D, Kitas G. (2011). Mean Platelet Volume: A Link Between Thrombosis and Inflammation? Current Pharmaceutical Design, 17(1), 47–58. doi:10.2174/138161211795049804.
  • 19. Varol E, Aksoy F, Ozaydin M, Erdogan D, Dogan A. (2014). Association between neutrophil–lymphocyte ratio and mitral annular calcification. Blood Coagulation & Fibrinolysis, 25(6), 557–560. doi:10.1097/mbc.0000000000000094.
  • 20. Battinelli E, Willoughby SR, Foxall T, Valeri CR, Loscalzo J. (2001). Induction of platelet formation from megakaryocytoid cells by nitric oxide. Proceedings of the National Academy of Sciences, 98(25), 14458–14463. doi:10.1073/pnas.241427398.
  • 21. Wu, M., Zhou, L., Zhu, D., Lai, T., Chen, Z., & Shen, H. (2018). Hematological indices as simple, inexpensive and practical severity markers of obstructive sleep apnea syndrome: a meta-analysis. Journal of Thoracic Disease, 10(12), 6509–6521. doi:10.21037/jtd.2018.10.105.
  • 22. Dunleavy M, Dooley M, Cox D, Bradford A. (2005). Chronic intermittent asphyxia increases platelet reactivity in rats. Experimental Physiology, 90(3), 411–416.
  • 23. Rahangdale S, Yeh SY, Novack V, Stevenson K, Barnard MR, Furman MI, Frelinger AL, Michelson AD, Malhotra A. (2011). The Influence of Intermittent Hypoxemia on Platelet Activation in Obese Patients with Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, 07(02), 172–178. doi:10.5664/jcsm.28105.
  • 24. Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, Chaves PA, Ershler WB, Longo DL. (2005). Proinflammatory state and circulating erythropoietin in persons with and without anemia. The American Journal of Medicine, 118(11), 1288.e11–1288.e19. doi:10.1016/j.amjmed.2005.06.039.
  • 25. Jennum P, Riha RL. (2009). Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. European Respiratory Journal, 33(4), 907–914. doi:10.1183/09031936.00180108.
  • 26. Huang KT, Chin CH, Tseng CC, Chang HC, Chen YC, Wang CC, Lin MC, Lin HC, Su MC. (2014). The Influence of Obesity on Different Genders in Patients with Obstructive Sleep Apnea. The Scientific World Journal, 2014, 1–8. doi:10.1155/2014/487215.
There are 26 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Recep Alanlı 0000-0003-4663-1898

Murat Bülent Küçükay 0000-0003-3657-6565

Serkan Yalçın 0000-0002-8028-1070

Publication Date April 30, 2021
Submission Date July 10, 2020
Published in Issue Year 2021 Volume: 10 Issue: 1

Cite

APA Alanlı, R., Küçükay, M. B., & Yalçın, S. (2021). New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio. Abant Medical Journal, 10(1), 32-39. https://doi.org/10.47493/abantmedj.2021.30
AMA Alanlı R, Küçükay MB, Yalçın S. New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio. Abant Med J. April 2021;10(1):32-39. doi:10.47493/abantmedj.2021.30
Chicago Alanlı, Recep, Murat Bülent Küçükay, and Serkan Yalçın. “New Hematological Indices As Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio”. Abant Medical Journal 10, no. 1 (April 2021): 32-39. https://doi.org/10.47493/abantmedj.2021.30.
EndNote Alanlı R, Küçükay MB, Yalçın S (April 1, 2021) New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio. Abant Medical Journal 10 1 32–39.
IEEE R. Alanlı, M. B. Küçükay, and S. Yalçın, “New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio”, Abant Med J, vol. 10, no. 1, pp. 32–39, 2021, doi: 10.47493/abantmedj.2021.30.
ISNAD Alanlı, Recep et al. “New Hematological Indices As Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio”. Abant Medical Journal 10/1 (April 2021), 32-39. https://doi.org/10.47493/abantmedj.2021.30.
JAMA Alanlı R, Küçükay MB, Yalçın S. New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio. Abant Med J. 2021;10:32–39.
MLA Alanlı, Recep et al. “New Hematological Indices As Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio”. Abant Medical Journal, vol. 10, no. 1, 2021, pp. 32-39, doi:10.47493/abantmedj.2021.30.
Vancouver Alanlı R, Küçükay MB, Yalçın S. New Hematological Indices as Simple and Practical Severity Markers of Obstructive Sleep Apnea Syndrome: Mean Platelet Volume/High Density Lipoprotein and Red-Cell Diameter Width/High Density Lipoprotein Ratio. Abant Med J. 2021;10(1):32-9.