Oğuz DİKBAŞ, Nilgün ERTEN, Fatma KÜÇÜKER, Özge YILMAZ AKŞEHİRLİ

7672

Enflamatuar Belirteç Olarak Nötrofil Lenfosit Oranı, Platelet Lenfosit Oranı gibi Hematolojik Parametrelerin Tıkayıcı Uyku Apne Sendromunun Şiddeti ile İlişkisinin Değerlendirilmesi

Amaç: Bu çalışmanın amacı tıkayıcı uyku apnesi (OSAS) olan hastalarda hematolojik parametrelerin değerlendirilmesidir.Gereç ve Yöntemler: Bu araştırmada uyku laboratuvarında Polisomnografi testi yapılan hastalar geriye dönük olarak değerlendirilmiştir. Kanser, kardiyovasküler hastalık, hematolojik bozukluk, enfeksiyon hastalıkları, romatolojik hastalıklar, renal ve hepatik yetmezlik olan hastalar çalışmaya alınmamıştır. Çalışmaya apne-hipopne endeksi 5 olaydan fazla olan 210 hasta ve 57 AHI 5 den az olan kontrol olarak alınmıştır. Araştırma grubu polisomnografideki AHI skorlarına göre 4 gruba ayrılmıştır: hafif OSAS (AHI= 5-15), orta OSAS (AHI=15- 30), ciddi OSAS (AHI> 30), ve kontrol (AHI<5). Hematolojik parametreler değerlendirilmiş ve karşılaştırılmıştır.Bulgular: Trombosit lenfosit oranı OSAS hastalarında kontrol grubuna göre anlamlı düşük saptanmıştır. (p = 0.050). OSAS ve kontrol grupları arasında nötrofil lenfosit oranı yönünden istatistiksel olarak anlamlı farklılık izlenmemiştir (p = 0.947). Serum trigliserid ve ortalama trombosit hacmi OSAS hastalarında anlamlı yüksek izlenmiştir (p < 0.0001; p = 0.043). Trombosit dağılım hacmi ciddi OSAS grubunda kontrol grubuna ve diğer OSAS alt gruplarına göre anlamlı yüksek saptanmıştır. (p = 0.014).Sonuç: OSAS ve NLR arasında herhangi bir ilişki izlenmemiştir. NLR, PLR, ve OSAS arasındaki olası ilişki üzerine hâlâ araştırmaların sonuçları tartışmalıdır.
Anahtar Kelimeler:

Tıkayıcı uyku apne sendromu, OSAS, Nötrofil lenfosit oranı, Platelet lenfosit oranı

Relationship of Potential Inflammatory Markers Namely Neutrophile Lymphocyte Ratio and Platelet Lymphocyte Ratio With the Severity of Obstructive Sleep Apnea

Aim: The aim of the present study is to evaluate hematological parameters in patients with obstructive sleep apnea syndrome (OSAS).Material and Methods: Patients underwent a polysomnographic (PSG) test at our sleep laboratory was retrospectively reviewed. Patients with cancer, cardiovascular disease, hematologic disorders, infectious diseases and rheumatologically disorders, renal or hepatic insufficiency were excluded from the study. Two hundred and ten OSAS patients with an apnea-hypopnea index (AHI) of more than five events and 57 controls with an AHI of less than four events were included. Study population was divided into four groups depending on the AHI as: mild OSAS (AHI= 5-15), moderate OSAS (AHI=15-30), severe OSAS (AHI>30), and the control (AHI<5). Hematologic parameters were measured and compared.Results: Platelet lymphocyte ratio was significantly lower in patients with OSAS compared to the control (p = 0.050). Neutrophil lymphocyte ratio between OSAS and the control was not different (p = 0.947). Serum triglyceride level and mean platelet volume were significantly higher in patients with OSAS (p < 0.0001; p = 0.043). Platelet distribution width was significantly higher in severe OSAS group compared to control, mild and moderate OSAS subgroups (0.014).Conclusion: No relationship was found between OSAS and NLR. There is a debate over putative relationship between NLR, PLR, and OSAS.
Keywords:

Obstructive sleep apnea syndrome, OSAS, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio,

PDF

___

  • 1. Gharibeh T, Mehra R. Obstructive sleep apnea syndrome: natural history, diagnosis, and emerging treatment options. Nature and science of sleep. 2010;2:233-55.
  • 2. Azagra-Calero E, Espinar-Escalona E, Barrera-Mora JM, Llamas-Carreras JM, Solano-Reina E. Obstructive sleep apnea syndrome (OSAS). Review of the literature. Medicina oral, patologia oral y cirugia bucal. 2012;17(6):e925-9.
  • 3. Maspero C, Giannini L, Galbiati G, Rosso G, Farronato G. Obstructive sleep apnea syndrome: a literature review. Minerva stomatologica. 2015;64(2):97-109.
  • 4. Munoz R, Duran-Cantolla J, Martinez-Vila E, Gallego J, Rubio R, Aizpuru F, et al. Severe sleep apnea and risk of ischemic stroke in the elderly. Stroke; a journal of cerebral circulation. 2006;37(9):2317-21.
  • 5. Partinen M. Epidemiology of obstructive sleep apnea syndrome. Current opinion in pulmonary medicine. 1995;1(6):482-7.
  • 6. Botros N, Concato J, Mohsenin V, Selim B, Doctor K, Yaggi HK. Obstructive sleep apnea as a risk factor for type 2 diabetes. The American journal of medicine. 2009;122(12):1122-7.
  • 7. Chen L, Pei JH, Chen HM. Effects of continuous positive airway pressure treatment on glycaemic control and insulin sensitivity in patients with obstructive sleep apnoea and type 2 diabetes: a meta-analysis. Archives of medical science : AMS. 2014;10(4):637-42.
  • 8. Destors M, Tamisier R, Baguet JP, Levy P, Pepin JL. [Cardiovascular morbidity associated with obstructive sleep apnea syndrome]. Revue des maladies respiratoires. 2014;31(4):375-85.
  • 9. Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O’Connor GT, Resnick HE, et al. Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. American journal of respiratory and critical care medicine. 2010;182(2):269-77.
  • 10. Ryan S, Taylor CT, McNicholas WT. Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome? Postgraduate medical journal. 2009;85(1010):693-8.
  • 11. Zamarron C, Valdes Cuadrado L, Alvarez-Sala R. Pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome. Pulmonary medicine. 2013;2013:521087.
  • 12. Castro-Anon O, Perez de Llano LA, De la Fuente Sanchez S, Golpe R, Mendez Marote L, Castro-Castro J, et al. Obesityhypoventilation syndrome: increased risk of death over sleep apnea syndrome. PloS one. 2015;10(2):e0117808.
  • 13. Ucar ZZ, Cirak AK, Olcay S, Uysal H, Demir AU, Ozacar R. Association of duration of sleep and cardiovascular and metabolic comorbidities in sleep apnea syndrome. Sleep disorders. 2012;2012:316232.
  • 14. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 1996;7(2):157-61.
  • 15. Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogeneity. Blood. 1988;72(1):1-8.
  • 16. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. The American journal of cardiology. 2010;105(2):186-91.
  • 17. Nilsson L, Wieringa WG, Pundziute G, Gjerde M, Engvall J, Swahn E, et al. Neutrophil/Lymphocyte ratio is associated with non-calcified plaque burden in patients with coronary artery disease. PloS one. 2014;9(9):e108183.
  • 18. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratislavske lekarske listy. 2001;102(1):5-14.
  • 19. Azab B, Shah N, Akerman M, McGinn JT, Jr. Value of platelet/ lymphocyte ratio as a predictor of all-cause mortality after non- ST-elevation myocardial infarction. Journal of thrombosis and thrombolysis. 2012;34(3):326-34.
  • 20. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PloS one. 2013;8(7):e67688.
  • 21. Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. Journal of thrombosis and thrombolysis. 2015;39(2):179-85.
  • 22. Yenigun A, Karamanli H. Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome. The Journal of laryngology and otology. 2015;129(9):887-92.
  • 23. Yasar Z, Buyuksirin M, Ucsular FD, Kargi A, Erdem F, Talay F, et al. Is an elevated neutrophil-to-lymphocyte ratio a predictor of metabolic syndrome in patients with chronic obstructive pulmonary disease? European review for medical and pharmacological sciences. 2015;19(6):956-62.
  • 24. Christoffersson G, Vagesjo E, Pettersson US, Massena S, Nilsson EK, Broman JE, et al. Acute sleep deprivation in healthy young men: impact on population diversity and function of circulating neutrophils. Brain, behavior, and immunity. 2014;41:162-72.
  • 25. Boudjeltia KZ, Faraut B, Stenuit P, Esposito MJ, Dyzma M, Brohee D, et al. Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: a pilot study. Vascular health and risk management. 2008;4(6):1467-70.
  • 26. Barcelo A, Pierola J, de la Pena M, Esquinas C, Fuster A, Sanchez-de-la-Torre M, et al. Free fatty acids and the metabolic syndrome in patients with obstructive sleep apnoea. The European respiratory journal. 2011;37(6):1418-23.
  • 27. Xu H, Yi H, Guan J, Yin S. Effect of continuous positive airway pressure on lipid profile in patients with obstructive sleep apnea syndrome: a meta-analysis of randomized controlled trials. Atherosclerosis. 2014;234(2):446-53.
  • 28. Li J, Zhang Y, Wang J, Feng P, Chen R, Cao Y, et al. [Association between serum lipoprotein lipase level and dyslipidemia in patients with obstructive sleep apnea syndrome]. Zhonghua yi xue za zhi. 2014;94(6):403-7.
  • 29. Chou YT, Chuang LP, Li HY, Fu JY, Lin SW, Yang CT, et al. Hyperlipidaemia in patients with sleep-related breathing disorders: prevalence & risk factors. The Indian journal of medical research. 2010;131:121-5.
  • 30. Parish JM, Adam T, Facchiano L. Relationship of metabolic syndrome and obstructive sleep apnea. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2007;3(5):467-72.
  • 31. Li J, Thorne LN, Punjabi NM, Sun CK, Schwartz AR, Smith PL, et al. Intermittent hypoxia induces hyperlipidemia in lean mice. Circulation research. 2005;97(7):698-706.
  • 32. Gunbatar H, Sertogullarindan B, Ekin S, Akdag S, Arisoy A, Sayhan H. The correlation between red blood cell distribution width levels with the severity of obstructive sleep apnea and carotid intima media thickness. Medical science monitor: international medical journal of experimental and clinical research. 2014;20:2199-204.
  • 33. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2003;9(3):177-90.
  • 34. Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. Journal of thrombosis and thrombolysis. 2006;22(3):161-4.
  • 35. Kurt OK, Yildiz N. The importance of laboratory parameters in patients with obstructive sleep apnea syndrome. Blood coagulation & fibrinolysis: An international journal in haemostasis and thrombosis. 2013;24(4):371-4.
  • 36. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28-32.
Türkiye Diyabet ve Obezite Dergisi -Cover
  • ISSN: 2587-0335
  • Yayın Aralığı: 3
  • Başlangıç: 2017
  • Yayıncı: Bülent Ecevit Üniversitesi Obezite ve Diyabet Uygulama ve Araştırma Merkezi
Arşiv
Sayıdaki Diğer Makaleler

Alloxan Diyabetli Sıçanlarda Extensor Digitorum Longus Kas Hücresi Membranlarının Lektin Boyaması

Nursel GÜL, Suna CEBESOY, Nesrin ÖZSOY

Adolesan Güreşçilerde Yirmi Dört Haftalık Egzersizin İnsülin Direnci Parametreleri ve Metabolik Profiller Üzerine Etkileri

Mustafa GÜMÜŞ, Taner BAYRAKTAROĞLU, İbrahim E. PİŞKİN, Tevfik C. AKALIN, Faruk YAMANER

Diyabetik Sıçanlarda Melatonin Uygulamasının Karaciğer, Böbrek, Mide, Pankreas ve Göz Dokularında Oksidatif Stres Üzerine Etkisi

Meryem ERGENÇ, Salim ÖZENOĞLU, İnci TURAN, Veysel Haktan ÖZAÇMAK, Hale SAYAN ÖZAÇMAK

Enflamatuar Belirteç Olarak Nötrofil Lenfosit Oranı, Platelet Lenfosit Oranı gibi Hematolojik Parametrelerin Tıkayıcı Uyku Apne Sendromunun Şiddeti ile İlişkisinin Değerlendirilmesi

Oğuz DİKBAŞ, Nilgün ERTEN, Fatma KÜÇÜKER, Özge YILMAZ AKŞEHİRLİ

Üçüncü Basamak Bir Hastaneye Başvuran Riskli Popülasyonda Oral Glukoz Tolerans Testi ile Diabetes Mellitus ve Prediyabet Prevalansının Tespiti

Safiye ÇATALÇAM, Ebru BOZ UZALDI, Dilek KARAKAYA ARPACI, Taner BAYRAKTAROĞLU, Muhammer BİLİCİ