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Hematological evaluation in males with obstructive Sleep apnea before and after positive airway pressure
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Orientador(es)
Resumo(s)
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.
Descrição
Palavras-chave
Sleep Apnea Obstructive sleep apnea syndrome (OSAS) Biomarkers of Cardiovascular Platelet parameters Red cell parameters Determinantes da Saude e da Doença Apneia do Sono
Contexto Educativo
Citação
Rev Port Pneumol. 2017;23(2):71-78
Editora
Elsevier/Sociedade Portuguesa de Pneumologia