Do complete blood count parameters predict diagnosis and disease severity in obstructive sleep apnea syndrome?

Abstract

OBJECTIVE: Inflammation and platelet activation play a role in the pathogenesis of obstructive sleep apnea syndrome (OSAS). In this study, it was aimed to investigate the effectiveness of the systemic inflammation markers, the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and WMR (white blood cell count (WBC) to mean platelet volume (MPV) ratio), in determining the severity of OSAS.

PATIENTS AND METHODS: The study included 207 patients who visited the pulmonology polyclinic between 1 and 31 January 2020 with complaints of snoring, apnea periods during sleep and sleepiness and were assessed with polysomnography (PSG) with the indication of hospitalization. The patients were grouped based on their apnea-hypopnea index (AHI) scores as 54 patients with AHI<5 as the control group, 41 patients with AHI=5-15 as the mild, 54 patients with AHI=15-30 as the moderate and 58 patients with AHI>30 as the severe OSAS groups. From the complete blood counts of the patients, NLR, PLR and WMR were calculated. The demographic characteristics of the patient and control groups were assessed by comparing PSG and blood parameters.

RESULTS: The mean age of the 207 patients included in the study was 54.56 +/- 10.24 years. Among the patients, 58.5% were male, and 41.5% were female. Between the control and OSAS groups, there were significant differences in terms of the WBC and lymphocyte counts (p=0.004 and p=0.035). In terms of the NLR and PLR values, there was no significant difference among the OSAS groups (p=0.723 and p=0.309). WMR had a significant difference in the OSAS groups (p=0.001). It was determined that WMR was valuable especially in distinguishing severe OSAS from the other groups.

CONCLUSIONS: In our study. where OSAS severity and complete blood count parameters assessed as inflammatory markers were examined, it was identified that the NLR and PLR levels were not very determinant in predicting either OSAS or its severity, and among these parameters, WMR was more significant, and it was determinant in distinguishing severe OSAS. Therefore, we believe it is needed to plan new studies without losing time over these markers in the diagnosis of OSAS, determination of its severity and its monitoring.