Mean Platelet Volume (MPV) in Obstructive Sleep Apnea (OSA) and Effect of Continuous Positive Airway Pressure (CPAP) Treatment on MPV in OSA

Year 2024, Volume: 16 Issue: 1, 32 - 41, 14.03.2024

Emine Banu Çakıroğlu Ali Nihat Annakkaya Kezban Özmen Süner Ümran Toru Erbay

https://doi.org/10.18521/ktd.1350048

Abstract

Aims: In this study, our objective was to evaluate mean platelet volume (MPV), an indirect marker of platelet activation, in patients with obstructive sleep apnea (OSA), and assess the effect of OSA treatment with continuous positive airway pressure (CPAP) on MPV
Methods: In this study, records of consecutive patients who underwent polysomnographic evaluation for OSA symptoms in the Sleep Disorders Laboratory during a one-year period were reviewed retrospectively. Patients who had both complete blood count and MPV measurements were included in the study.
Results: A total of 158 patients, including 51 females (32.3%) and 107 males (67.7%), were included in the study. The mean age of the patients was 51±13 (min-18, max-82) years. OSA was detected in 74.1% (117/158) of the patients. It was determined that as the severity of OSA increased, hemoglobin and hematocrit values increased significantly. There was no significant difference in platelet count according to the presence and severity of OSA. The MPV was significantly lower in severe OSA cases compared to those without OSA and mild OSA cases. A negative correlation was observed between MPV and the apnea-hypopnea index, desaturation index, and the amount of oxygen saturation below 90% during sleep. There was no significant difference in median erythrocyte and thrombocyte counts, hematocrit percentage and hemoglobin values before and after treatment in OSA patients who used CPAP therapy. However, a significant decrease in MPV was observed after OSA treatment compared to pre-treatment. (p=0.021).
Conclusions: The results of the study do not support an increase in MPV and hence platelet activation in severe OSA patients compared with those without OSA. However, the results suggest that one month of CPAP treatment reduces MPV and thus platelet activation in severe OSA patients. Further controlled, prospective studies including treatment outcomes are needed on this subject.

Keywords

sleep apnea, mean platelet volume, obstructive sleep apnea, platelets

Ethical Statement

Non-Invasive Clinical Research Ethics Committee of Düzce University Faculty of Medicine Number: 2012/309

Obstrüktif Uyku Apnede (OUA) Ortalama Trombosit Hacmi (OTH) ve OUA'da Sürekli Pozitif Hava Yolu Basıncı (CPAP) Tedavisinin OTH Üzerine Etkisi

Abstract

Amaç: Bu çalışmada amacımız, obstrüktif uyku apnesi (OUA) olan hastalarda trombosit aktivasyonunun dolaylı bir belirteci olan ortalama trombosit hacmini (OTH) değerlendirmek ve sürekli pozitif hava yolu basıncı (CPAP) ile OUA tedavisinin OTH üzerindeki etkisini değerlendirmektir.
Metot: Bu çalışmada, Uyku Bozuklukları Laboratuvarı'nda bir yıl boyunca OSA semptomları nedeniyle polisomnografik değerlendirme yapılan ardışık hastaların kayıtları retrospektif olarak incelendi. Çalışmaya hem tam kan sayımı hem de MPV ölçümü yapılan hastalar dahil edildi.
Bulgular: Çalışmaya 51 kadın (%32.3) ve 107 erkek (%67.7) olmak üzere toplam 158 hasta dahil edildi. Hastaların yaş ortalaması 51±13 (min-18, maks-82) yıldı. Hastaların %74,1'inde (117/158) OSA saptandı. OSA şiddeti arttıkça hemoglobin ve hematokrit değerlerinin anlamlı olarak arttığı belirlendi. Trombosit sayısında OSA varlığı ve şiddetine göre anlamlı bir fark yoktu. MPV, ağır OSA olgularında OSA olmayanlara ve hafif OSA olgularına kıyasla anlamlı derecede düşüktü. OTH ile apne-hipopne indeksi, desatürasyon indeksi ve uyku sırasında %90'ın altındaki oksijen satürasyonu miktarı arasında negatif bir korelasyon gözlendi. CPAP tedavisi kullanan OSA hastalarında tedavi öncesi ve sonrası medyan eritrosit ve trombosit sayıları, hematokrit yüzdesi ve hemoglobin değerlerinde anlamlı bir fark bulunmadı. Bununla birlikte, OSA tedavisi sonrasında tedavi öncesine kıyasla MPV'de anlamlı bir düşüş gözlendi. (p=0.021).
Sonuç: Çalışmanın sonuçları, OSA'sı olmayanlara kıyasla ağır OSA hastalarında MPV'de ve dolayısıyla trombosit aktivasyonunda bir artışı desteklememektedir. Ancak, sonuçlar bir aylık CPAP tedavisinin ağır OUA hastalarında MPV'yi ve dolayısıyla trombosit aktivasyonunu azalttığını düşündürmektedir. Bu konuda tedavi sonuçlarını içeren daha ileri kontrollü, prospektif çalışmalara ihtiyaç vardır.

Keywords

Uyku Apne, ortalama trombosit hacmi, obstruktif uyku apne, trombositler

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