Abstract
Giriş: Obstrüktif Uyku Apne Sendromu (OUAS) yaygın bir uyku hastalığıdır. Yüksek CRP düzeylerinin şiddetli OUAS durumunda yükseldiği saptanmıştır. CRP/Prealbümin (CRP/PAB) oranı ölüm riski ve kötü sonuçlar açısından yeni bir indekstir. CRP/PAB oranı ile OUAS şiddetini kıyaslanması amaçlanmıştır. Materyal ve Metod: Kesitsel bu çalışmada OUAS tanılı 99 hasta (ortalama yaş: 54.34±10.3) AHI kriterine dayalı olarak OUAS şiddeti durumuna göre hafif (n: 28 [28.3%]), orta (n:23 [23.2%]) ve şiddetli (n:48 [48.5%]) 3 sınıfa ayrılmıştır. Bulgular: Ortalama CRP/PAB oranı gruplar arasında benzer saptandı (hafif: 0.03± 0.03; orta: 0.02 ± 0.02, şiddetli: 0.03 ± 0.04, p=0.759). Demografik ve bazal özellikler gruplar arasında benzer saptandı. CRP/PAB oranı ile yaş, BMI, şeker, nötrofil, platelet ve monocit değerleri ile pozitif yönde ve Hgb, MCH, MCHC değerleri ile negatif yönde zayıf korelasyon saptandı (p<0.05). Tüm grupların değerlendirilmesinde regresyon analizi CRP/PAB oranı ile uyku süresi, apne ve hipopne indeksleri arasında zayıf ama anlamlı pozitif ilişki saptandı. Ayrıca uyku etkinliği ile zayıf ama anlamlı negatif ilişki saptandı (tümü için p<0.05). Sonuç: Her ne kadar CRP/PAB oranı ile OUAS şiddeti arasında anlamlı bağlantı saptanmasa da CRP/PAB oranı ile BMI, monosit sayısı arasında pozitif ama zayıf bir korelasyon ve apne ve hipopne indeksleri ile düşük düzeyde ilişki saptandı bu CRP/PAB oranının OUAS'daki inflamasyonun anlamlı bir belirteci olabileceğini ifade eder.
Keywords
References
- Framnes SN, Arble DM. The Bidirectional Relationship Between Obstructive Sleep Apnea and Metabolic Disease. Front. Endocrinol. 2018; 9: 440
- Tie YX, Fu YY, Xu Z. Peng Y. Relationship between C-reactive protein levels and obstructive sleep apnea syndrome. Genet. Mol. Res. 2016 May 25;15(2).
- Davis CJ, Sowa D, Keim KS, Kinnare K, Peterson S. The Use of Prealbumin and C-Reactive Protein for Monitoring Nutrition Support in Adult Patients Receiving Enteral Nutrition in an Urban Medical Center. Journal of Parenteral and Enteral Nutrition. 2012 Mar;36(2):197-204.
- Molfino A, Heymsfield SB, Zhu F, Kotanko P, Levin NW, Dwyer T, et al. Prealbumin is Associated with Visceral Fat Mass in Hemodialysis Patients. Ren Nutr. 2013 November; 23(6): 406–410
- Wang W, Ren D, Wang CS, Li T, Yao HC. High sensitivity C-reactive protein to prealbumin ratio measurement as a marker of the prognosis in acute coronary syndrome. Scientific Reports. 2019; 9: 11583
- Li L, Dai L, Wang X, Wang Y, Zhou L, Chen M, et al. Predictive value of the C-reactive protein-to-prealbumin ratio in medical ICU patients. Biomark Med. 2017 Apr; 11(4): 329-337.
- Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017; 13(3): 479–504
- Bouloukaki I, Mermigkis C, Kallergis EM, Moniaki V, Mauroidi E, Schize SE. Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein. World J Exp Med. 2015 May 20; 5(2): 77-83
- Kokturk O, Ciftci TU, Mollarecep E, Ciftci B. Elevated C-Reactive Protein Levels and Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Syndrome. Int Heart J. 2005; 46: 801-809.
- Ryan S, Nolan GM, Hannigan E, Cunningham S, Taylor C, McNicholas WT. Cardiovascular risk markers in obstructive sleep apnoea syndrome and correlation with obesity. Thorax. 2007; 62: 509–51.
- Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Lee T, et al. Endothelial Dysfunction and C-Reactive Protein in Relation with the Severity of Obstructive Sleep Apnea Syndrome. SLEEP. 2007; 30(8): 997-1001.
- Archontogeorgis K, Nena E, Papanas N, Steiropoulos P. Biomarkers to Improve Diagnosis and Monitoring of Obstructive Sleep Apnea Syndrome: Current Status and Future Perspectives. Hindawi Publishing Corporation. Pulmonary Medicine. 2014;2014: 930535.
- Wand W, Wang CS, Ren D, Li T, Yao HC, Ma SJ. Low serum prealbumin levels on admission can independently predict in-hospital adverse cardiac events in patients with acute coronary syndrome. Medicine. 2018; 97:30(e11740).
- Zuo P, Tong S, Yan Q, Cheng L, Li Y, Song K, et al. Decreased prealbumin level is associated with increased risk for mortality in elderly hospitalized patients with COVID-19. Nutrition. 2020; 78:110930
- Xie Q, Zhou Y, Xu Z, Yang Y, Kuang D, You H, et al. The ratio of CRP to prealbumin levels predict mortality in patients with hospital-acquired acute kidney injury. BMC Nephrology. 2011; 12(30)
- Pinilla JC, Hayes P, Laverty W, Arnold C, Laxdal V. The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. Surgery. 1998 Oct; 124(4): 799-805.
The Relationship Between Disease Severity and CRP/Prealbumin Ratio in Individuals Diagnosed with Obstructive Sleep Apnea Syndrome
Abstract
Introduction: Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder. Higher CRP levels has been found to rise in severe OSAS. The CRP/Prealbumin (CRP/PAB) ratio is a new index of risk of death and poor outcomes. We aimed to compare the CRP/PAB ratio with the severity of OSAS. Material and Methods: In this cross-sectional study, 99 patients with OSAS (mean age=54.34±10.3) were classified into three categories based on severity of OSAS into mild (n: 28 [28.3%]), moderate (n:23 [23.2%]), and severe (n:48 [48.5%]) based on AHI criteria. Results: The mean CRP/PAB ratios were similar among the groups (mild: 0.03± 0.03; moderate=0.02 ± 0.02; severe=0.03 ± 0.04; p=0.759). The demographic and baseline features were similar between the groups. The CRP/PAB ratio had a weak positive correlation with the age, BMI, glucose, neutrophil, platelet and monocyte values and a weak negative correlation with the Hgb, MCH and MCHC values (p<0.05). Considering all groups in the regression analysis, it was showed that low levels of positive and significant relationship between the CRP/PAB and sleep duration and the apnea and hypopnea indices. It was also showed low-level of negative and significant relationship with sleep efficiency (p<0.05 for all). Conclusion: Although, there was no significant between the CRP/PAB ratio and the severity of OSAS, it was showed that low-level positive correlation between CRP/PAB ratio and BMI, monocyte count and low-level relationship with the apnea and hypopnea indices and it may indirectly mean that CRP/PAB ratio may be a significant marker of inflammation in OSAS.
Keywords
References
- Framnes SN, Arble DM. The Bidirectional Relationship Between Obstructive Sleep Apnea and Metabolic Disease. Front. Endocrinol. 2018; 9: 440
- Tie YX, Fu YY, Xu Z. Peng Y. Relationship between C-reactive protein levels and obstructive sleep apnea syndrome. Genet. Mol. Res. 2016 May 25;15(2).
- Davis CJ, Sowa D, Keim KS, Kinnare K, Peterson S. The Use of Prealbumin and C-Reactive Protein for Monitoring Nutrition Support in Adult Patients Receiving Enteral Nutrition in an Urban Medical Center. Journal of Parenteral and Enteral Nutrition. 2012 Mar;36(2):197-204.
- Molfino A, Heymsfield SB, Zhu F, Kotanko P, Levin NW, Dwyer T, et al. Prealbumin is Associated with Visceral Fat Mass in Hemodialysis Patients. Ren Nutr. 2013 November; 23(6): 406–410
- Wang W, Ren D, Wang CS, Li T, Yao HC. High sensitivity C-reactive protein to prealbumin ratio measurement as a marker of the prognosis in acute coronary syndrome. Scientific Reports. 2019; 9: 11583
- Li L, Dai L, Wang X, Wang Y, Zhou L, Chen M, et al. Predictive value of the C-reactive protein-to-prealbumin ratio in medical ICU patients. Biomark Med. 2017 Apr; 11(4): 329-337.
- Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017; 13(3): 479–504
- Bouloukaki I, Mermigkis C, Kallergis EM, Moniaki V, Mauroidi E, Schize SE. Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein. World J Exp Med. 2015 May 20; 5(2): 77-83
- Kokturk O, Ciftci TU, Mollarecep E, Ciftci B. Elevated C-Reactive Protein Levels and Increased Cardiovascular Risk in Patients with Obstructive Sleep Apnea Syndrome. Int Heart J. 2005; 46: 801-809.
- Ryan S, Nolan GM, Hannigan E, Cunningham S, Taylor C, McNicholas WT. Cardiovascular risk markers in obstructive sleep apnoea syndrome and correlation with obesity. Thorax. 2007; 62: 509–51.
- Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Lee T, et al. Endothelial Dysfunction and C-Reactive Protein in Relation with the Severity of Obstructive Sleep Apnea Syndrome. SLEEP. 2007; 30(8): 997-1001.
- Archontogeorgis K, Nena E, Papanas N, Steiropoulos P. Biomarkers to Improve Diagnosis and Monitoring of Obstructive Sleep Apnea Syndrome: Current Status and Future Perspectives. Hindawi Publishing Corporation. Pulmonary Medicine. 2014;2014: 930535.
- Wand W, Wang CS, Ren D, Li T, Yao HC, Ma SJ. Low serum prealbumin levels on admission can independently predict in-hospital adverse cardiac events in patients with acute coronary syndrome. Medicine. 2018; 97:30(e11740).
- Zuo P, Tong S, Yan Q, Cheng L, Li Y, Song K, et al. Decreased prealbumin level is associated with increased risk for mortality in elderly hospitalized patients with COVID-19. Nutrition. 2020; 78:110930
- Xie Q, Zhou Y, Xu Z, Yang Y, Kuang D, You H, et al. The ratio of CRP to prealbumin levels predict mortality in patients with hospital-acquired acute kidney injury. BMC Nephrology. 2011; 12(30)
- Pinilla JC, Hayes P, Laverty W, Arnold C, Laxdal V. The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. Surgery. 1998 Oct; 124(4): 799-805.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | June 30, 2022 |
| Submission Date | January 26, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 2 |
