The relationship between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with obstructive sleep apnea syndrome

Öz

Objective: There is a strong relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease (CVD). Chronic intermittent hypoxia, inflammation, oxidative stress, and endothelial dysfunction may create etiologic mechanisms, connection between OSAS to CVD. Inflammation play an important role in the development of CVD. Platelet- Lymphocyte Ratio (PLR) and Neutrophil-lymphocyte Ratio (NLR) are new biomarkers showing inflammation. This study was designed to investigate the association between PLR, NLR and relationship between severity of OSAS, polysomnographic parameters and PLR.

Methods: This was a cohort study in which patients who had undergone a full night polysomnography for diagnosis of OSA were recruited. Patients were divided according to their apnea hypopnea index (AHI) scores into OSAS negative simple snoring (Group 1; AHI <5 times/hours), mild (Group 2; AHI: 5-15), moderate (Group 3; AHI:15-30), and severe OSAS (Group 4; AHI >30) groups.

Results: A total of 111 patients were included in this study. There were 26, 22 and 63 patients in Groups 1, 2 and 3, respectively. PLR were significantly different between groups (Group 1: 87.12, Group 2: 103.6, Group 3: 112.5, p < 0.05). PLR were significantly correlated with NLR, AHI, oxygen desaturation index, average and minimum O2 saturation values (p < 0.05). Multiple regression analysis demonstrated that PLR is an independent predictor of CVD. PLR cut-off value for demonstrating the presence of CVD is higher than 86.03.

Conclusion: In the light of these findings, PLR is strongly associated with the severity of OSAS. PLR might be used as a biomarker to predict CVD in OSAS patients.

Key words: obstructive sleep apnea, inflammation, platelet to lymphocyte ratio

Anahtar Kelimeler

• obstructive sleep apnea, inflammation, platelet to lymphocyte ratio

Obstruktif uyku apne sendromunda platelet lenfosit oranı ve nötrofil lenfosit oranı ilişkisi

Öz

Amaç: Obstruktif Uyku Apne Sendromu (OSAS) ile Kardiyovasküler Hastalıklar (KVH) arasında güçlü bir ilişki vardır. Kronik intermittan hipoksi, inflamasyon, oksidatif stres ve endotelyal disfonksiyon OSAS ve KVH arasındaki etyolojik mekanizmaları ortaya çıkarmış olabilir. İnflamasyon KVH gelişiminde önemli rol oynar. Platelet Lenfosit Oranı (PLO) ve Nötrofil Lenfosit Oranı (NLO) inflamasyonu gösteren yeni belirteçlerdir. Bu çalışma PLO ve NLO arasındaki ilişkiyi ve OSAS şiddeti, polisomnografik parametreler ve PLR arasındaki ilişkiyi araştırmaktadır. Yöntemler: OSAS ön tanısı ile tüm gece polisomnografisi yapılan hastaların çalışmaya dahil edildiği bir kohort çalışması planlandı. Hastalar apne hipopne indeksi skorlarına göre sınıflandırıldı. Basit horlama (Grup 1; AHİ <5 adet/saat), hafif OSAS , orta derece OSAS ve ağrı OSAS (Grup 4; AHİ >30). Bulgular: 111 hasta çalışmaya dahil edildi. Grup 1, 2 ve 3 ‘te sırasıyla 26, 22 ve 63 hasta vardı. PLO gruplar arasında anlamlı düzeyde değişiklik göstermekteydi. Grup 1’de 87,12, Grup2’de 103,6, Grup 3’te 112,5 idi (p < 0.05). PLO ile NLO, AHİ, oksijen desaturasyon indeksi, ortalama ve minimum oksijen saturasyon değeri arasında anlamlı derecede ilişki vardı (p<0.05). Çoklu regresyon analizi ile PLO’ nun KVH için bağımsız bir belirleyici olduğu saptandı. KVH varlığında, PLO cut off değerinin 86,03 olduğu gösterildi. Sonuç: Tüm bu bulgular ışığında PLO ile OSAS şiddeti arasında güçlü ilişki vardır. PLO OSAS hastalarında KVH varlığını belirlemede bir belirteç olarak kullanılabilir

Anahtar Kelimeler

• obstruktif uyku apnesi, inflamasyon, platelet lenfosit oranı

Kaynakça

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