Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure.
Obstructive sleep apnea syndrome (OSAS) is a systemic inflammatory disease associated with cardiovascular consequences. Red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) are recognized biomarkers of cardiovascular morbidity/mortality. Limited data is available on the association between these parameters and OSAS severity and the relationship with positive airway pressure therapy (PAP). In this prospective study of male OSAS patients we analyzed hematological data in order to evaluate their value in predicting OSAS severity, the relationship with sleep parameters, and their behavior under PAP. Seventy-three patients were included (mean age 46.5 years), of which 36 were mild (49.3%), 10 moderate (13.7%), and 27 severe (37%). The mean RDW increased significantly with OSAS severity and showed a positive correlation with respiratory disturbance index and hypoxemic burdens. Additionally, a group of 48 patients (mean age 47.2 years) were submitted to PAP. After six months, red blood cell count, hemoglobin, hematocrit, and platelet count showed a significant decrease (p<0.0001; p<0.0001; p=0.001; p<0.0001; respectively). Concerning OSAS severity, these parameters also significantly decreased in mild patients (p=0.003; p=0.043; p=0.020; p=0.014; respectively) but only hemoglobin, hematocrit, and platelet count decreased in severe cases (p<0.0001; p=0.008; p=0.018; respectively). This study demonstrated an association between RDW values and OSAS severity. Moreover, red cell and platelet parameters changed significantly after PAP, supporting its cardiovascular protective effect. RDW may become a simple/inexpensive blood biomarker, making it useful in prioritizing OSAS patients waiting for polysomnography, and red cell and platelet parameters could be useful in PAP follow up.
Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa, Portugal. Electronic address: amelia.feliciano@chln.min-saude.pt.
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Feliciano
Pneumology in Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal.
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Linhas
Pneumology in Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal.
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Marçôa
Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
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Cysneiros
Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
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Martinho
Cardiology Unit in Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa, Portugal.
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Reis
Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal.
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Penque
Sleep and Non Invasive Ventilation Unit in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; ISAMB-Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
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Pinto
Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; ISAMB-Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
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Bárbara
D000328:Adult; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000628:therapy*
MPV; OSAS; PAP; PDW; Platelet parameters; RDW; Red cell parameters