title: Importance of laboratory parameters in patients with obstructive sleep apnea and their relationship with cardiovascular diseases.
abstract: BACKGROUND
  Ostructive sleep apnea (OSA) is an independent risk factor for the development of cardiovascular events. Platelet activation and inflammation are the mechanisms involved in the association between OSA and cardiovascular disease (CVD). The markers of platelet activation and inflammation are the mean platelet volume (MPV), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), neutrophil- lymphocyte ratio (NLR). We aimed to define the association of NLR, PLR, RDW, and MPV with the severity of disease and the presence of CVD.
  
  
  METHODS
  This study consisted of 300 patients who were admitted to the sleep laboratory. The patients were classified according to their apnea- hypopnea index (AHI) scores as OSA negative (Group A: AHI<5), mild (Group B: AHI: 5-15), moderate (Group C: AHI=15-30), and severe OSA (Group D: AHI >30).
  
  
  RESULTS
  There were no significant differences in the NLR, PLR, and MPV among the groups (P>.05); only RDW differed significantly (P=.04). RDW was significantly higher in patients with than without risk factors for CVD [15.6% (15.4-15.7) vs 15.3% (15.1-15.3), respectively; P=.02].
  
  
  CONCLUSIONS
  NLR, PLR, MPV, and RDW are widely available and easily obtained from a routinely performed hemogram. Among these laboratory parameters, only RDW can demonstrate the reverse consequences of OSA-associated comorbidities, because vascular damage due to systemic inflammation is an important underlying mechanism in these diseases. RDW might be used as a marker of the response and patient compliance with continuous positive airway pressure treatment.
authors.affiliation: Department of Pulmonary Diseases, Başkent University School of Medicine, Konya, Turkey.
authors.forename: Tulay
authors.initials: T
authors.lastname: Kıvanc
authors.affiliation: Department of Biochemistry, Başkent University School of Medicine, Konya, Turkey.
authors.forename: Sevsen
authors.identifier: http://orcid.org/0000-0002-7613-2240
authors.initials: S
authors.lastname: Kulaksızoglu
authors.affiliation: Department of Pulmonary Diseases, Başkent University School of Medicine, Alanya, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Lakadamyalı
authors.affiliation: Department of Pulmonary Diseases, Başkent University School of Medicine, Ankara, Turkey.
authors.forename: Fusun
authors.initials: F
authors.lastname: Eyuboglu
mesh_terms: D000328:Adult; D001772:Blood Cell Count / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology; D004909:Erythrocyte Indices / Q000502:physiology; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications / Q000453:epidemiology
keywords: cardiovascular disease; lymphocyte; neutrophil; obstructive sleep apnea; red cell distribution width