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Obstruktif Uyku Apne Sendromu Tanılı Hastalarda Hematolojik Parametrelerin Değerlendirilmesi; Tek Merkez Deneyimi

Year 2024, Volume: 9 Issue: 3, 102 - 106, 31.12.2024
https://doi.org/10.55694/jamer.1583306

Abstract

Amaç: Obstruktif uyku apne sendromu (OUAS), üst solunum yollarında tam veya kısmi tıkanma ile hava akışının bozulması ile
solunumda duraksama veya hava akışında azalmayla karakterize bir hastalıktır. OUAS’ta sistemik inflamatuvar belirteçlerin
arttığı ve buna bağlı hematolojik parametrelerde değişiklik olabileceği bilinmektedir. Çalışmamızda amacımız Uyku Merkezine
başvuran ve OUAS düşünülerek polisomnografi yapılan hastaların hematolojik parametrelerini değerlendirmektir.
Gereç ve Yöntemler: Bu çalışmada Uyku Merkezine başvuran ve OUAS düşünülerek polisomnografi yapılan, 18 yaş ve üzeri
351 hastanın dosyası tarandı. Hastalar Apne-Hipopne indeksine göre basit horlama veya OUAS olarak gruplandı. Hastaların
hematolojik parametreleri dosyalarından kaydedildi. OUAS varlığı ile bu parametrelerdeki değişiklikler değerlendirildi.
Bulgular: 271 hasta OUAS tanısı alırken, 78 hasta basit horlama kabul edildi. OUAS tanısı alan hastaların yaş ortalaması
50,46±11,08 idi. Beyaz küre sayısı, ortalama trombosit hacmi ve eritrosit dağılım genişliği açısından gruplar arasında
istatistiksel olarak anlamlı fark saptanırken, hemoglobin düzeyi, nötrofil sayısı, lenfosit sayısı ve nötrofil lenfosit oranı
açısından fark yoktu.
Sonuç: OUAS hematolojik bulgularda değişikliklere neden olabilecek kronik bir hastalıktır. Hematolojik bulgularda oluşabilecek
değişikliklerin daha büyük hasta grubunda, prospektif olarak yapılması, polisomnografi gibi zor ulaşılan bir tetkiki kimlere
daha öncelikli yapalım sorusunun yanıtını daha ucuz ve kolay ulaşılabilir bir testle belirlememize olanak verebilir.

References

  • 1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993 Apr 29;328(17):1230-1235.
  • 2. Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Ann Intern Med. 2005;142(3):187-197.
  • 3. Köktürk O, Kemaloğlu Y, Köktürk N. Habitüel horlaması olan olgularda obstrüktif sleep apne sendromu prevalansı. Tüberk Toraks. 1997. 45:7-11.
  • 4. Tishler PV, Larkin EK, Schluchter MD, Redline S. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleepdisordered breathing. JAMA. 2003;289(17):2230-2237.
  • 5. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006-1014.
  • 6. Senaratna CV, English DR, Currier D, Perret JL, Lowe A, Lodge C, et al. Sleep apnoea in Australian men: disease burden, comorbidities, and correlates from the Australian longitudinal study on male health. BMC Public Health. 2016;16(Suppl 3):1029.
  • 7. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. 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.
  • 8. Maniaci A, Iannella G, Cocuzza S, Vicini C, Magliulo G, Ferlito S, et al. Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients. J Clin Med. 2021;10(2): 277.
  • 9. Stanek A, Brozyna-Tkaczyk K, Myslinski W. Oxidative stress markers among obstructive sleep apnea pwatients. Oxid Med Cell Longev. 2021;2021:9681595.
  • 10. Yamauchi M, Kimura H. Oxidative stress in obstructive sleep apnea: putative pathways to cardiovascular complications. Antioxid Redox Signal. 2008;10(4):755-768.
  • 11. Hong SN, Yun HC, Yoo JH, Lee SH. Association between hypercoagulability and severe obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg. 2017;143(10):996-1002.
  • 12. Puurunen MK, Hwang SJ, Larson MG, Vasan RS, O’Donnell CJ, Tofler G, Johnson AD. ADP platelet hyperreactivity predicts cardiovascular disease in the FHS (Framingham Heart Study). J Am Heart Assoc. 2018;7(5):e008522.
  • 13. Langer HF, Gawaz M. Platelet-vessel wall interactions in atherosclerotic disease. Thromb Haemost. 2008;99(3):480-486
  • 14. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost. 2003;9(3):177-190.
  • 15. Kanbay A, Tutar N, Kaya E, Buyukoglan H, Ozdogan N, Oymak FS, et al. Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blood Coagul Fibrinolysis. 2013;24(5):532-536.
  • 16. Karakas MS, Altekin RE, Baktir AO, Kucuk M, Cilli A, Yalcinkaya S. Association between mean platelet volume and severity of disease in patients with obstructive sleep apnea syndrome without risk factors for cardiovascular disease. Turk Kardiyol Dern Ars. 2013;41(1):14-20.
  • 17. Oga T, Chin K, Tabuchi A, Kawato M, Morimoto T, Takahashi K, et al. Effects of obstructive sleep apnea with intermittent hypoxia on platelet aggregability. J Atheroscler Thromb. 2009;16(6):862- 869.
  • 18. Kany S, Vollrath JT, Relja B. Cytokines in Inflammatory Disease. Int J Mol Sci. 2019 Nov 28;20(23):6008.
  • 19. Shetty S, Chandrashekhar S, Chaya SK, Surendran A, Dey D. Role of neutrophil to lymphocyte ratio in predicting severity of obstructive sleep apnea. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5003-5007.
  • 20. Korkmaz M, Korkmaz H, Kucuker F, Ayyildiz SN, Cankaya S. Evaluation of the association of sleep apnea-related systemic inflammation with CRP, ESR, and neutrophil-to-lymphocyte ratio. Med Sci Monit. 2015;21.477-481.
  • 21. Meir H., Kryger TR, William C. D. Principles and Practice of Sleep Medicine. Chapter 87 - Clinical Features and Evaluation of Obstructive Sleep Apnea-Hypopnea Syndrome and Upper Airway Resistance Syndrome. Fourth edition, 2005.
  • 22. Dikbaş O, Erten N, Küçüker F, Akşehirli ÖY. Enflamatuar belirteç olarak nötrofil lenfosit oranı, platelet lenfosit oranı gibi hematolojik parametrelerin tıkayıcı uyku apne sendromunun şiddeti ile ilişkisinin değerlendirilmesi. Türkiye Diyabet ve Obezite Dergisi. 2017;1(3):125-131.
  • 23. Fietze I, Laharnar N, Obst A, Ewert R, Felix SB, Garcia C, et al. Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend. J Sleep Res. 2019;28(5): e12770.
  • 24. Bruyneel M, Veltri F, Poppe K. Prevalence of newly established thyroid disorders in patients with moderate-to-severe obstructive sleep apnea syndrome. Sleep Breath. 2019;23(2).567-573.
  • 25. Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoglu D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2009;28(1):46-51.
  • 26. Duksal F, Eren F. Evaluation of thyroid functions and obesity in obstructive sleep apnea syndrome. Rev Assoc Med Bras (1992). 2023;69(9):e20230376.
  • 27. Doring Y, Drechsler M, Soehnlein O, Weber C. Neutrophils in atherosclerosis: from mice to man. Arterioscler Thromb Vasc Biol. 2015;35(2).288-295.
  • 28. Soehnlein O. Multiple roles for neutrophils in atherosclerosis. Circ Res. 2012;110(6):875-888.
  • 29. Geovanini GR, Wang R, Weng J, Tracy R, Jenny NS, Goldberger AL, et al. Elevations in neutrophils with obstructive sleep apnea: The Multi-Ethnic Study of Atherosclerosis (MESA). Int J Cardiol. 2018;257:318-323.
  • 30. Altintas N, Cetinoglu E, Yuceege M, Acet AN, Ursavas A, Firat H, Karadag M. Neutrophil-to-lymphocyte ratio in obstructive sleep apnea; a multi center, retrospective study. Eur Rev Med Pharmacol Sci. 2015;19(17):3234-3240.
  • 31. Rha MS, Kim CH, Yoon JH, Cho HJ. Association between the neutrophil-to-lymphocyte ratio and obstructive sleep apnea: a meta-analysis. Sci Rep. 2020;10(1):10862.
  • 32. Durmaz DY, Gunes A. Is there a relationship between hematological parameters and duration of respiratory events in severe OSA. Aging Male. 2020;23(2):125-131.
  • 33. Cavusoglu E, Chopra V, Gupta A, Battala VR, Poludasu S, Eng C, Marmur JD. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol. 2010;141(2):141-146.
  • 34. Osawa Y, Tanaka T, Semba RD, Fantoni G, Moaddel R, Candia J, et al. Proteins in the pathway from high red blood cell width distribution to all-cause mortality. EBioMedicine. 2022;76:103816. Epub 20220119.
  • 35. Ycas JW. Toward a Blood-Borne Biomarker of Chronic Hypoxemia: Red Cell Distribution Width and Respiratory Disease. Adv Clin Chem. 2017;82:105-197.
  • 36. Di Lorenzo B, Pau MC, Zinellu E, Mangoni AA, Paliogiannis P, Pirina P, et al. Association between Red Blood Cell Distribution Width and Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-Analysis. J Clin Med. 2023;12(9).
  • 37. Lee CH, Khoo SM, Chan MY, Wong HB, Low AF, Phua QH, et al. Severe obstructive sleep apnea and outcomes following myocardial infarction. J Clin Sleep Med. 2011;7(6):616-621.
  • 38. Atan D, Sazak Kundi FC, Ozcan KM, Dere H. [The relationship between platelet count and mean platelet volume with obstructive sleep apnea syndrome]. Kulak Burun Bogaz Ihtis Derg. 2015;25(5):289-294.
  • 39. Hoffmann P, Mest HJ. What about the effects of dietary lipids on endogenous prostanoid synthesis? A state-of-the-art review. Biomed Biochim Acta. 1987;46(7):639-650.
  • 40. Nena E, Papanas N, Steiropoulos P, Zikidou P, Zarogoulidis P, Pita E, et al. Mean platelet volume and platelet distribution width in non-diabetic subjects with obstructive sleep apnoea syndrome: new indices of severity? Platelets. 2012;23(6):447-454.
  • 41. Varol E, Ozturk O, Gonca T, Has M, Ozaydin M, Erdogan D, Akkaya A. Mean platelet volume is increased in patients with severe obstructive sleep apnea. Scand J Clin Lab Invest. 2010;70(7):497-502.

Evaluation of Hematologic Parameters in Patients with Obstructive Sleep Apnea Syndrome; Single Center Experience

Year 2024, Volume: 9 Issue: 3, 102 - 106, 31.12.2024
https://doi.org/10.55694/jamer.1583306

Abstract

Aim: Obstructive sleep apnea syndrome (OSAS) is a disease characterized by complete or partial obstruction of the upper
airways and impaired airflow, resulting in pauses in breathing or decreased airflow. The aim of our study was to evaluate the
hematologic parameters of patients who applied to the Sleep Center and underwent polysomnography for OSAS.
Materials and Methods: In this study, we reviewed the files of 351 patients aged 18 years and older who applied to the Sleep
Center and underwent polysomnography for OSAS. Patients were grouped as simple snoring or OSAS according to ApneaHypopnea index. Hematologic parameters of the patients were recorded from their files. Changes in these parameters with the
presence of OSAS were evaluated.
Results: 271 patients were diagnosed with OSAS, while 78 patients were considered to have simple snoring. The mean age of
the patients diagnosed with OSAS was 50.46±11.08 years. There were statistically significant differences between the groups in
white blood cell count, mean platelet volume and erythrocyte distribution width, but not in hemoglobin level, neutrophil count,
lymphocyte count and neutrophil to lymphocyte ratio.
Conclusion: OSAS is a chronic disease that may cause changes in hematologic findings. Prospective study of changes in
hematologic findings in a larger group of patients may allow us to determine the answer to the question of who should prioritize
a difficult to access test such as polysomnography with a cheaper and easily accessible test.

References

  • 1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993 Apr 29;328(17):1230-1235.
  • 2. Caples SM, Gami AS, Somers VK. Obstructive sleep apnea. Ann Intern Med. 2005;142(3):187-197.
  • 3. Köktürk O, Kemaloğlu Y, Köktürk N. Habitüel horlaması olan olgularda obstrüktif sleep apne sendromu prevalansı. Tüberk Toraks. 1997. 45:7-11.
  • 4. Tishler PV, Larkin EK, Schluchter MD, Redline S. Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleepdisordered breathing. JAMA. 2003;289(17):2230-2237.
  • 5. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006-1014.
  • 6. Senaratna CV, English DR, Currier D, Perret JL, Lowe A, Lodge C, et al. Sleep apnoea in Australian men: disease burden, comorbidities, and correlates from the Australian longitudinal study on male health. BMC Public Health. 2016;16(Suppl 3):1029.
  • 7. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. 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.
  • 8. Maniaci A, Iannella G, Cocuzza S, Vicini C, Magliulo G, Ferlito S, et al. Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients. J Clin Med. 2021;10(2): 277.
  • 9. Stanek A, Brozyna-Tkaczyk K, Myslinski W. Oxidative stress markers among obstructive sleep apnea pwatients. Oxid Med Cell Longev. 2021;2021:9681595.
  • 10. Yamauchi M, Kimura H. Oxidative stress in obstructive sleep apnea: putative pathways to cardiovascular complications. Antioxid Redox Signal. 2008;10(4):755-768.
  • 11. Hong SN, Yun HC, Yoo JH, Lee SH. Association between hypercoagulability and severe obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg. 2017;143(10):996-1002.
  • 12. Puurunen MK, Hwang SJ, Larson MG, Vasan RS, O’Donnell CJ, Tofler G, Johnson AD. ADP platelet hyperreactivity predicts cardiovascular disease in the FHS (Framingham Heart Study). J Am Heart Assoc. 2018;7(5):e008522.
  • 13. Langer HF, Gawaz M. Platelet-vessel wall interactions in atherosclerotic disease. Thromb Haemost. 2008;99(3):480-486
  • 14. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost. 2003;9(3):177-190.
  • 15. Kanbay A, Tutar N, Kaya E, Buyukoglan H, Ozdogan N, Oymak FS, et al. Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blood Coagul Fibrinolysis. 2013;24(5):532-536.
  • 16. Karakas MS, Altekin RE, Baktir AO, Kucuk M, Cilli A, Yalcinkaya S. Association between mean platelet volume and severity of disease in patients with obstructive sleep apnea syndrome without risk factors for cardiovascular disease. Turk Kardiyol Dern Ars. 2013;41(1):14-20.
  • 17. Oga T, Chin K, Tabuchi A, Kawato M, Morimoto T, Takahashi K, et al. Effects of obstructive sleep apnea with intermittent hypoxia on platelet aggregability. J Atheroscler Thromb. 2009;16(6):862- 869.
  • 18. Kany S, Vollrath JT, Relja B. Cytokines in Inflammatory Disease. Int J Mol Sci. 2019 Nov 28;20(23):6008.
  • 19. Shetty S, Chandrashekhar S, Chaya SK, Surendran A, Dey D. Role of neutrophil to lymphocyte ratio in predicting severity of obstructive sleep apnea. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5003-5007.
  • 20. Korkmaz M, Korkmaz H, Kucuker F, Ayyildiz SN, Cankaya S. Evaluation of the association of sleep apnea-related systemic inflammation with CRP, ESR, and neutrophil-to-lymphocyte ratio. Med Sci Monit. 2015;21.477-481.
  • 21. Meir H., Kryger TR, William C. D. Principles and Practice of Sleep Medicine. Chapter 87 - Clinical Features and Evaluation of Obstructive Sleep Apnea-Hypopnea Syndrome and Upper Airway Resistance Syndrome. Fourth edition, 2005.
  • 22. Dikbaş O, Erten N, Küçüker F, Akşehirli ÖY. Enflamatuar belirteç olarak nötrofil lenfosit oranı, platelet lenfosit oranı gibi hematolojik parametrelerin tıkayıcı uyku apne sendromunun şiddeti ile ilişkisinin değerlendirilmesi. Türkiye Diyabet ve Obezite Dergisi. 2017;1(3):125-131.
  • 23. Fietze I, Laharnar N, Obst A, Ewert R, Felix SB, Garcia C, et al. Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend. J Sleep Res. 2019;28(5): e12770.
  • 24. Bruyneel M, Veltri F, Poppe K. Prevalence of newly established thyroid disorders in patients with moderate-to-severe obstructive sleep apnea syndrome. Sleep Breath. 2019;23(2).567-573.
  • 25. Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoglu D. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2009;28(1):46-51.
  • 26. Duksal F, Eren F. Evaluation of thyroid functions and obesity in obstructive sleep apnea syndrome. Rev Assoc Med Bras (1992). 2023;69(9):e20230376.
  • 27. Doring Y, Drechsler M, Soehnlein O, Weber C. Neutrophils in atherosclerosis: from mice to man. Arterioscler Thromb Vasc Biol. 2015;35(2).288-295.
  • 28. Soehnlein O. Multiple roles for neutrophils in atherosclerosis. Circ Res. 2012;110(6):875-888.
  • 29. Geovanini GR, Wang R, Weng J, Tracy R, Jenny NS, Goldberger AL, et al. Elevations in neutrophils with obstructive sleep apnea: The Multi-Ethnic Study of Atherosclerosis (MESA). Int J Cardiol. 2018;257:318-323.
  • 30. Altintas N, Cetinoglu E, Yuceege M, Acet AN, Ursavas A, Firat H, Karadag M. Neutrophil-to-lymphocyte ratio in obstructive sleep apnea; a multi center, retrospective study. Eur Rev Med Pharmacol Sci. 2015;19(17):3234-3240.
  • 31. Rha MS, Kim CH, Yoon JH, Cho HJ. Association between the neutrophil-to-lymphocyte ratio and obstructive sleep apnea: a meta-analysis. Sci Rep. 2020;10(1):10862.
  • 32. Durmaz DY, Gunes A. Is there a relationship between hematological parameters and duration of respiratory events in severe OSA. Aging Male. 2020;23(2):125-131.
  • 33. Cavusoglu E, Chopra V, Gupta A, Battala VR, Poludasu S, Eng C, Marmur JD. Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography. Int J Cardiol. 2010;141(2):141-146.
  • 34. Osawa Y, Tanaka T, Semba RD, Fantoni G, Moaddel R, Candia J, et al. Proteins in the pathway from high red blood cell width distribution to all-cause mortality. EBioMedicine. 2022;76:103816. Epub 20220119.
  • 35. Ycas JW. Toward a Blood-Borne Biomarker of Chronic Hypoxemia: Red Cell Distribution Width and Respiratory Disease. Adv Clin Chem. 2017;82:105-197.
  • 36. Di Lorenzo B, Pau MC, Zinellu E, Mangoni AA, Paliogiannis P, Pirina P, et al. Association between Red Blood Cell Distribution Width and Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-Analysis. J Clin Med. 2023;12(9).
  • 37. Lee CH, Khoo SM, Chan MY, Wong HB, Low AF, Phua QH, et al. Severe obstructive sleep apnea and outcomes following myocardial infarction. J Clin Sleep Med. 2011;7(6):616-621.
  • 38. Atan D, Sazak Kundi FC, Ozcan KM, Dere H. [The relationship between platelet count and mean platelet volume with obstructive sleep apnea syndrome]. Kulak Burun Bogaz Ihtis Derg. 2015;25(5):289-294.
  • 39. Hoffmann P, Mest HJ. What about the effects of dietary lipids on endogenous prostanoid synthesis? A state-of-the-art review. Biomed Biochim Acta. 1987;46(7):639-650.
  • 40. Nena E, Papanas N, Steiropoulos P, Zikidou P, Zarogoulidis P, Pita E, et al. Mean platelet volume and platelet distribution width in non-diabetic subjects with obstructive sleep apnoea syndrome: new indices of severity? Platelets. 2012;23(6):447-454.
  • 41. Varol E, Ozturk O, Gonca T, Has M, Ozaydin M, Erdogan D, Akkaya A. Mean platelet volume is increased in patients with severe obstructive sleep apnea. Scand J Clin Lab Invest. 2010;70(7):497-502.
There are 41 citations in total.

Details

Primary Language Turkish
Subjects Chest Diseases, ​Internal Diseases
Journal Section Makale
Authors

Emine Uslu 0000-0002-4717-3000

Abdulsamet Erden 0000-0002-8084-2018

Oğuzhan Bol 0000-0002-7323-0355

Hatice Karagöz 0000-0002-9891-5211

Publication Date December 31, 2024
Submission Date November 11, 2024
Acceptance Date December 17, 2024
Published in Issue Year 2024 Volume: 9 Issue: 3

Cite

Vancouver Uslu E, Erden A, Bol O, Karagöz H. Obstruktif Uyku Apne Sendromu Tanılı Hastalarda Hematolojik Parametrelerin Değerlendirilmesi; Tek Merkez Deneyimi. JAMER. 2024;9(3):102-6.