Reticulocytes in untreated obstructive sleep apnoea.
OBJECTIVE
The short, repetitive hypoxaemic episodes observed in obstructive sleep apnoea (OSA) may determine small augmentations in mature red blood cells. It is unknown whether they affect reticulocyte release. This study explored whether the number and degree of maturation of circulating reticulocytes may be altered in OSA, possibly through the effect of erythropoietin.


METHODS
Fifty male adult patients with suspected OSA, normoxic during wakefulness, were studied. After nocturnal polysomnography, a blood sample was withdrawn for blood cells count, erythropoietin, iron and transferrin determination. Reticulocyte concentration and degree of immaturity [high (H), medium (M), or low (L)] were also determined. Immature reticulocyte fraction (IRF) was calculated as (M+H) percentage of reticulocytes.


RESULTS
A wide range of OSA severity was found [apnoea/hypopnoea index (AHI): 44.3 +/- 30.4, range 0.3-105; sleep time spent at oxyhaemoglobin saturation <90%: 18.1 +/- 22.2%, range 0-81%]. Both reticulocyte count and IRF slightly exceeded the normal range. Patients with a reticulocyte concentration > 2% had higher EPO levels (p < 0.05), but not worse nocturnal desaturations, than those with values < 2%. By contrast, subjects with IRF < 15% showed worse desaturations (p < 0.05), but similar EPO concentrations, when compared to subjects whose IRF was < 10%. At univariate analysis, reticulocyte count correlated to erythropoietin, while IRF to transferrin saturation, BMI and OSA severity. At multiple regression, only lowest nocturnal oxygen saturation remained a significant contributor to IRF (r2 0.223, p < 0.05).


CONCLUSIONS
This data suggests that hypoxaemia due to OSA could influence the release of immature reticulocytes, but this effect is not mediated by erythropoietin.
Marrone
O
O
National Research Council, Institute of Biomedicine and Molecular Immunology (IBIM), Palermo. marrone@ibim.cnr.it
Salvaggio
A
A
Gioia
M
M
Bonanno
A
A
Profita
M
M
Riccobono
L
L
Zito
A
A
Insalaco
G
G
Bonsignore
M R
MR
D000328:Adult; D015331:Cohort Studies; D004920:Erythropoiesis / Q000502:physiology; D004921:Erythropoietin / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D017701:Reticulocyte Count; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications; D014168:Transferrin / Q000378:metabolism
D014168:Transferrin; D004921:Erythropoietin