Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome and Their Correlation with Disease Severity

Yıl 2024, , 44 - 48, 31.08.2024

Kübra Mehel Metin , Selda Keskin Güler , Seçil Özercan , Tahir Yoldaş

https://doi.org/10.20492/aeahtd.1287208

Öz

ÖZET:
AMAÇ: Obstrüktif uyku apne sendromu (OUAS) uyku boyunca üst hava yolunun tekrarlayıcı şekilde, tam veya kısmen tıkanmasıyla karakterize bir durumdur. Etiyopatogenezinde inflamasyon rol aldığı gösterilmiştir. Bu çalışmanın amacı inflamasyon belirteçleri olarak önerilen parametrelerin kliniğimizde OUAS tanısı alan hastalarda incelenmesidir.
GEREÇ VE YÖNTEM: 2016-2019 yılları arasında polisomnografi yapılan 80 hasta çalışmaya dahil edildi. Apne hipopne indeksi (AHİ) 30’un üstü ağır OUAS (n=20), 15-30 arası orta OUAS (n=20), 5-15 arası olanlar hafif OUAS (n=20), olarak gruplandırıldı. AHI 5’in altında olanlar kontrol grubu olarak çalışmaya alındı (n=20). Kontrol grubu ile OUAS saptanan grup ve OUAS şiddetine göre ayrılmış gruplar arasında monosit/HDL, trombosit/lenfosit, nötrofil/lenfosit oranları, sedimentasyon, CRP, hsCRP, homosistein değerleri karşılaştırıldı.
BULGULAR: Kontrol ve OUAS olan gruplar cinsiyet açısından benzerdi. Ağır şiddette OUAS olan grubun yaş ortalaması diğer gruplara göre daha yüksekti. Gruplar arasında trombosit/lenfosit oranları, nötrofil/lenfosit oranları, monosit/HDL oranları, sedimentasyon, homosistein ve hsCRP değerleri açısından istatistiksel anlamlı fark saptanmadı (p>0.05). Kontrol ve OUAS grupları arasında ağır OUAS grubunda CRP düzeyi yüksek olup anlamlı istatistiksel fark saptandı (p<0.05). Kontrol ve OUAS grubu arasında trombosit/lenfosit oranları, nötrofil/lenfosit oranları, monosit/HDL oranları, sedimentasyon, homosistein, hsCRP ve CRP oranları arasında anlamlı fark saptanmadı. CRP seviye-leri AHI, desaturasyon indeksi, oksijen saturasyonu %90’ın altında geçen süre, vücut kitle indeksi (VKİ) ve yaşla pozitif; minimum oksijen saturasyonu ve ortalama oksijen saturasyonuyla negatif korelasyon göstermekteydi. hsCRP ise desaturasyon indeksi, oksijen saturasyonu %90’ın altında geçen süre, VKİ ve yaşla pozitif; minimum oksijen saturasyonu ve ortalama oksijen saturasyonuyla negatif korelasyon gösterdi.
TARTIŞMA: Ağır şiddette OUAS hastalarında diğer gruplara göre CRP oranları yüksek saptanmış olup ağır şiddette OUAS hastalarında inflamasyon açısından değerlendirebileceğimiz bir parametre olabilir.
SONUÇ: CRP ağır şiddette OUAS hastalarında inflamasyon açısından değerlendirebileceğimiz bir parametre olabilir.
ANAHTAR KELİMELER: High density lipoprotein, monosit, nötrofil, lenfosit, CRP, obstrüktif uyku apne sendromu

ABSTRACT
AIM: Obstructive sleep apnea syndrome (OSAS) is a condition characterized by repetitive, complete or partial obstruction of the upper airway during sleep. Inflammation has been shown to play a role in its etiopathogenesis. The aim of this study is to examine the parameters suggested as inflammati-on markers in patients diagnosed with OSAS in our clinic.
MATERIAL AND METHOD: Eighty patients who underwent polysomnography between 2016-2019 were in-cluded in the study. Apnea hypopnea index (AHI) above 30 was grouped as severe OSAS (n=20), 15-30 as moderate OSAS (n=20), 5-15 as mild OSAS (n=20). Those with AHI <5 were included in the study as the control group (n=20). Monocyte/HDL, platelet/lymphocyte, neutrophil/lymphocyte ratios, sedimentation, CRP, hsCRP, homocysteine values were compared between the control group and the group with OSAS and the groups separated according to the severity of OSAS.
RESULTS: The control and OSAS groups were similar in terms of gender. The mean age of the group with severe OSAS was higher than the other groups. There was no statistically significant difference between the groups in terms of platelet/lymphocyte ratios, neutrophil/lymphocyte ratios, mono-cyte/HDL ratios, sedimentation, homocysteine and hsCRP values (p>0.05). CRP level was high in the severe OSAS group and a statistically significant difference was found between the control and OSAS groups (p<0.05). There was no significant difference in platelet/lymphocyte ratios, neutro-phil/lymphocyte ratios, monocyte/HDL ratios, sedimentation, homocysteine, hsCRP and CRP ratios between the control and OSAS groups. CRP levels have showed positive with AHI, desaturation index, time elapsed below 90%, body mass index, and age; showed a negative correlation with mi-nimum oxygen saturation and mean oxygen saturation. hsCRP is positive with desaturation index, time elapsed below 90%, body mass index and age; showed a negative correlation with the minimum oxygen saturation and the mean oxygen saturation.
DISCUSSION: CRP rates were found to be higher in severe OSAS patients compared to other groups, and it may be a paramater that we can evaluate in terms of inflammation in severe OSAS patients.
CONCLUSION: CRP may be a paramater that we can evaluate in terms of inflammation in severe OSAS patients.
KEYWORDS: High density lipoprotein, monocytes, neutrophils, lymphocytes, CRP, obstructive sleep apnea syndrome.

Anahtar Kelimeler

High density lipoprotein, monocytes, neutrophils, lymphocytes, CRP

Proje Numarası

YOK

Obstruktif Uyku Apne Sendromunda İnflamasyon Biyobelirteçleri ve Hastalık Şiddeti İle İlişkisi

Öz

ÖZ:
Amaç: Obstrüktif uyku apne sendromu (OUAS) uyku boyunca üst hava yolunun tekrarlayıcı şekil-de, tam veya kısmen tıkanmasıyla karakterize bir durumdur. Etiyopatogenezinde inflamasyon rol aldığı gösterilmiştir. Bu çalışmanın amacı inflamasyon belirteçleri olarak önerilen parametrelerin kliniğimizde OUAS tanısı alan hastalarda incelenmesidir.
Gereç ve Yöntem: 2016-2019 yılları arasında polisomnografi yapılan 80 hasta çalışmaya dahil edildi. Apne hipopne indeksi (AHİ) 30’un üstü ağır OUAS (n=20), 15-30 arası orta OUAS (n=20), 5-15 arası olanlar hafif OUAS (n=20), olarak gruplandırıldı. AHI 5’in altında olanlar kontrol grubu olarak çalışmaya alındı (n=20). Kontrol grubu ile OUAS saptanan grup ve OUAS şiddetine göre ayrılmış gruplar arasında monosit/HDL, trombosit/lenfosit, nötrofil/lenfosit oranları, sedimentasyon, CRP, hsCRP, homosistein değerleri karşılaştırıldı.
Bulgular: Kontrol ve OUAS olan gruplar cinsiyet açısından benzerdi. Ağır şiddette OUAS olan grubun yaş ortalaması diğer gruplara göre daha yüksekti. Gruplar arasında trombosit/lenfosit oranları, nötrofil/lenfosit oranları, monosit/HDL oranları, sedimentasyon, homosistein ve hsCRP değerleri açısından istatistiksel anlamlı fark saptanmadı (p>0.05). Kontrol ve OUAS grupları arasında ağır OUAS grubunda CRP düzeyi yüksek olup anlamlı istatistiksel fark saptandı (p<0.05). Kontrol ve OUAS grubu arasında trombosit/lenfosit oranları, nötrofil/lenfosit oranları, monosit/HDL oranları, sedimentasyon, homosistein, hsCRP ve CRP oranları arasında anlamlı fark saptanmadı. CRP seviye-leri AHI, desaturasyon indeksi, oksijen saturasyonu %90’ın altında geçen süre, vücut kitle indeksi (VKİ) ve yaşla pozitif; minimum oksijen saturasyonu ve ortalama oksijen saturasyonuyla negatif korelasyon göstermekteydi. hsCRP ise desaturasyon indeksi, oksijen saturasyonu %90’ın altında geçen süre, VKİ ve yaşla pozitif; minimum oksijen saturasyonu ve ortalama oksijen saturasyonuyla negatif korelasyon gösterdi.
Tartışma: Ağır şiddette OUAS hastalarında diğer gruplara göre CRP oranları yüksek saptanmış olup ağır şiddette OUAS hastalarında inflamasyon açısından değerlendirebileceğimiz bir parametre olabilir.
Sonuç: CRP OUAS hastalarında inflamasyon açısından değerlendirebileceğimiz bir parametre olabilir.

Anahtar kelimeler: High density lipoprotein, monosit, nötrofil, lenfosit, CRP, obstrüktif uyku apne sendromu

ABSTRACT:

Aim: Obstructive sleep apnea syndrome (OSAS) is a condition characterized by repetitive, complete or partial obstruction of the upper airway during sleep. Inflammation has been shown to play a role in its etiopathogenesis. The aim of this study is to examine the parameters suggested as inflammati-on markers in patients diagnosed with OSAS in our clinic.
Material-Method: Eighty patients who underwent polysomnography between 2016-2019 were in-cluded in the study. Apnea hypopnea index (AHI) above 30 was grouped as severe OSAS (n=20), 15-30 as moderate OSAS (n=20), 5-15 as mild OSAS (n=20). Those with AHI <5 were included in the study as the control group (n=20). Monocyte/HDL, platelet/lymphocyte, neutrophil/lymphocyte ratios, sedimentation, CRP, hsCRP, homocysteine values were compared between the control group and the group with OSAS and the groups separated according to the severity of OSAS.
Results: The control and OSAS groups were similar in terms of gender. The mean age of the group with severe OSAS was higher than the other groups. There was no statistically significant difference between the groups in terms of platelet/lymphocyte ratios, neutrophil/lymphocyte ratios, mono-cyte/HDL ratios, sedimentation, homocysteine and hsCRP values (p>0.05). CRP level was high in the severe OSAS group and a statistically significant difference was found between the control and OSAS groups (p<0.05). There was no significant difference in platelet/lymphocyte ratios, neutro-phil/lymphocyte ratios, monocyte/HDL ratios, sedimentation, homocysteine, hsCRP and CRP ratios between the control and OSAS groups. CRP levels have showed positive with AHI, desaturation index, time elapsed below 90%, body mass index, and age; showed a negative correlation with mi-nimum oxygen saturation and mean oxygen saturation. hsCRP is positive with desaturation index, time elapsed below 90%, body mass index and age; showed a negative correlation with the minimum oxygen saturation and the mean oxygen saturation.
Discussıon: CRP rates were found to be higher in severe OSAS patients compared to other groups, and it may be a paramater that we can evaluate in terms of inflammation in severe OSAS patients.
Conclusıon: CRP may be a paramater that we can evaluate in terms of inflammation in severe OSAS patients.

Keywords: High density lipoprotein, monocytes, neutrophils, lymphocytes, CRP, obstructive sleep apnea syndrome.

Anahtar Kelimeler

High density lipoprotein, monosit, nötrofil, lenfosit, CRP, obstrüktif uyku apne sendromu

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

YOK

Kaynakça

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