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Obstrüktis Uyku Apnesi Olan Hastalarda Hastalık Şiddeti ile CRP/Prealbümin Oranı Arasındaki İlişki

Year 2022, , 49 - 61, 30.06.2022
https://doi.org/10.55517/mrr.1062670

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.

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

Year 2022, , 49 - 61, 30.06.2022
https://doi.org/10.55517/mrr.1062670

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.

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.
There are 16 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Yalçın Boduroğlu 0000-0002-6327-8849

Duygu Zorlu 0000-0002-2379-024X

Bilal İlanbey 0000-0002-7614-281X

Arzu Ertürk 0000-0002-8139-6750

Publication Date June 30, 2022
Submission Date January 26, 2022
Published in Issue Year 2022

Cite

Vancouver Boduroğlu Y, Zorlu D, İlanbey B, Ertürk A. The Relationship Between Disease Severity and CRP/Prealbumin Ratio in Individuals Diagnosed with Obstructive Sleep Apnea Syndrome. MRR. 2022;5(2):49-61.