Original article
Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure
A. Felicianoa,b,, , R. Linhasc, R. Mar????ac, A. Cysneirosa, C. Martinhod, R.P. Reise,b, D. Penquef, P. Pintog,h,i, C. B??rbarad,h,i
a Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
b Faculdade de Ci??ncias M??dicas da Universidade Nova de Lisboa, Lisboa, Portugal
c Pneumology in Servi??o de Pneumologia, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
d Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
e Cardiology Unit in Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
f Departamento de Gen??tica Humana, Instituto Nacional de Sa??de Dr. Ricardo Jorge, Lisboa, Portugal
g Sleep and Non Invasive Ventilation Unit in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
h Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
i ISAMB-Instituto de Sa??de Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
Received 17 July 2016, Accepted 27 December 2016
Abstract

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.

Keywords
RDW, MPV, PDW, Red cell parameters, Platelet parameters, OSAS, PAP

Metrics

  • Impact Factor: 1.560(2016)
  • 5-years Impact Factor: 1,100
  • SCImago Journal Rank (SJR):0,29
  • Source Normalized Impact per Paper (SNIP):0,685