Kurt Ozlem Kar, Yildiz Nebil
Department of Chest Diseases, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
Blood Coagul Fibrinolysis. 2013 Jun;24(4):371-4. doi: 10.1097/MBC.0b013e32835d53d4.
Platelet activation and inflammation are the related mechanisms of pathogenesis in obstructive sleep apnea syndrome (OSAS). Mean platelet volume (MPV) and platelet distribution width (PDW) are the markers of platelet activation. C-reactive protein (CRP) and red cell distribution width (RDW) in relation to the inflammation in OSAS might be increased. We aimed to investigate the correlation of the MPV, PDW, and RDW levels with the severity of OSAS. We included 98 patients with suspected OSAS, evaluated by polysomnography. According to their apnea-hypopnea index (AHI), patients were divided into group A (n = 20; 20.4%) with AHI below 5/h; group B (n = 15; 15.3%) with AHI 5-14.9/h; group C (n = 26; 26.5%) with AHI 15-29.9/h; and group D (n = 37; 37.8%) with AHI ≥30/h. Hemoglobin, MPV, PDW, and RDW were measured using an automated blood cell counter. BMI and age showed a statistically significant and gradual increase in AHI groups. Hemoglobin, platelet, CRP, MPV, and RDW values did not differ between AHI groups. PDW was significantly higher in group D (mean value 14.4 ± 1.8) than in group A (13.2 ± 0.5) (P < 0.001). Epworth sleepiness scale was significantly higher in group D (9.9 ± 5.5) than in group A (5.6 ± 3.5), B (9.2 ± 3.6) and C (6.6 ± 3.8) (P = 0.005). When the four groups were compared, group D had the lowest minimum SpO2 value [group A (89.4 ± 3.0), B (86.7 ± 4.2), C (81.2 ± 6.4), and D (68.2 ± 13.0)]. There was a statistically significant correlation between AHI and age (r = 0.35, P < 0.001), BMI (r = 0.31, P = 0.003), PDW (r = 0.28, P = 0.006), and Epworth sleepiness scale (r = 0.29, P = 0.007). However, AHI was not correlated with CRP, MPV, and RDW. PDW is higher in severe OSAS and is correlated with different parameters of breathing function during sleep. The severity of OSAS was not correlated with CRP, MPV, and RDW. These findings show an evidence for platelet activation in OSAS and suggest that PDW might be related markers of OSAS severity.
血小板活化和炎症是阻塞性睡眠呼吸暂停综合征（OSAS）发病机制中的相关机制。平均血小板体积（MPV）和血小板分布宽度（PDW）是血小板活化的标志物。与OSAS炎症相关的C反应蛋白（CRP）和红细胞分布宽度（RDW）可能会升高。我们旨在研究MPV、PDW和RDW水平与OSAS严重程度之间的相关性。我们纳入了98例疑似OSAS患者，通过多导睡眠图进行评估。根据呼吸暂停低通气指数（AHI），患者被分为A组（n = 20；20.4%），AHI低于5次/小时；B组（n = 15；15.3%），AHI为5 - 14.9次/小时；C组（n = 26；26.5%），AHI为15 - 29.9次/小时；D组（n = 37；37.8%），AHI≥30次/小时。使用自动血细胞计数器测量血红蛋白、MPV、PDW和RDW。BMI和年龄在AHI组中呈统计学显著且逐渐增加。AHI组之间血红蛋白、血小板、CRP、MPV和RDW值无差异。D组的PDW（平均值14.4±1.8）显著高于A组（13.2±0.5）（P < 0.001）。Epworth嗜睡量表在D组（9.9±5.5）显著高于A组（5.6±3.5）、B组（9.2±3.6）和C组（6.6±3.8）（P = 0.005）。当比较四组时，D组的最低SpO2值最低[A组（89.4±3.0）、B组（86.7±4.2）、C组（81.2±6.4）和D组（68.2±13.0）]。AHI与年龄（r = 0.35，P < 0.001）、BMI（r = 0.31，P = 0.003）、PDW（r = 0.28，P = 0.006）和Epworth嗜睡量表（r = 0.29，P = 0.007）之间存在统计学显著相关性。然而，AHI与CRP、MPV和RDW无关。严重OSAS患者的PDW较高，且与睡眠期间呼吸功能的不同参数相关。OSAS的严重程度与CRP、MPV和RDW无关。这些发现为OSAS中的血小板活化提供了证据，并表明PDW可能是OSAS严重程度的相关标志物。
