Associations Between Systemic Inflammatory Markers Based on Blood Cells and Polysomnographic Factors in Obstructive Sleep Apnea
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Objectives. Systemic inflammation plays a key role in the pathogenesis of obstructive sleep apnea (OSA); however, easy-to-use methods to evaluate the severity of systemic inflammation have yet to be developed. This study investigatedthe association between systemic inflammation markers that could be derived from the complete blood count (CBC)profile and sleep parameters in a large number of patients with OSA. Methods. Patients who visited our hospital’s Otorhinolaryngology Sleep Clinic between January 2017 and April 2022 un-derwent polysomnography and routine laboratory tests, including a CBC. Associations between three systemic in-flammatory markers—the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and plate-let-lymphocyte ratio (PLR)—and polysomnographic and demographic factors including age, sex, body mass index,the apnea-hypopnea index (AHI), the hypopnea index (HI), lowest oxygen saturation (%), the Pittsburgh Sleep Qual-ity Index (PSQI), the Epworth Sleepiness Scale, and percentages of non-rapid eye movement (REM) sleep stage 3,REM sleep, and snoring time were analyzed. The inflammation markers were compared among OSA subgroups, andassociations were also analyzed in subgroups with different OSA severities. Results. In total, 1,102 patients (968 men and 134 women) were included, and their mean AHI was 33.0±24.3. PSQI wassignificantly associated with SII (P =0.027). No independent significant factors were identified for the NLR or PLR. Within the simple snoring and mild OSA subgroups, no significant association was found between sleep parametersand the SII. In the severe OSA subgroup, the AHI (P =0.004) and PSQI (P =0.012) were independently associatedwith the SII. Conclusion. Our study analyzed systemic inflammatory markers based on the CBC, a simple, relatively cost-effective test,and showed that the AHI and SII were significantly correlated only in the severe OSA subgroup.
Abstract
Objectives. Systemic inflammation plays a key role in the pathogenesis of obstructive sleep apnea (OSA); however, easy-to-use methods to evaluate the severity of systemic inflammation have yet to be developed. This study investigatedthe association between systemic inflammation markers that could be derived from the complete blood count (CBC)profile and sleep parameters in a large number of patients with OSA. Methods. Patients who visited our hospital’s Otorhinolaryngology Sleep Clinic between January 2017 and April 2022 un-derwent polysomnography and routine laboratory tests, including a CBC. Associations between three systemic in-flammatory markers—the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and plate-let-lymphocyte ratio (PLR)—and polysomnographic and demographic factors including age, sex, body mass index,the apnea-hypopnea index (AHI), the hypopnea index (HI), lowest oxygen saturation (%), the Pittsburgh Sleep Qual-ity Index (PSQI), the Epworth Sleepiness Scale, and percentages of non-rapid eye movement (REM) sleep stage 3,REM sleep, and snoring time were analyzed. The inflammation markers were compared among OSA subgroups, andassociations were also analyzed in subgroups with different OSA severities. Results. In total, 1,102 patients (968 men and 134 women) were included, and their mean AHI was 33.0±24.3. PSQI wassignificantly associated with SII (P =0.027). No independent significant factors were identified for the NLR or PLR. Within the simple snoring and mild OSA subgroups, no significant association was found between sleep parametersand the SII. In the severe OSA subgroup, the AHI (P =0.004) and PSQI (P =0.012) were independently associatedwith the SII. Conclusion. Our study analyzed systemic inflammatory markers based on the CBC, a simple, relatively cost-effective test,and showed that the AHI and SII were significantly correlated only in the severe OSA subgroup.
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