阻塞性睡眠呼吸暂停中基于血细胞的全身炎症标志物与多导睡眠图因素之间的关联
Associations Between Systemic Inflammatory Markers Based on Blood Cells and Polysomnographic Factors in Obstructive Sleep Apnea.
作者信息
Kim Minju, Cho Sung-Woo, Won Tae-Bin, Rhee Chae-Seo, Kim Jeong-Whun
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
出版信息
Clin Exp Otorhinolaryngol. 2023 May;16(2):159-164. doi: 10.21053/ceo.2022.01368. Epub 2023 Mar 6.
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 investigated the 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 underwent polysomnography and routine laboratory tests, including a CBC. Associations between three systemic inflammatory markers-the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-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 Quality 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, and associations 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 was significantly 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 parameters and the SII. In the severe OSA subgroup, the AHI (P=0.004) and PSQI (P=0.012) were independently associated with 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.
目的
全身炎症在阻塞性睡眠呼吸暂停（OSA）的发病机制中起关键作用；然而，尚未开发出易于使用的评估全身炎症严重程度的方法。本研究调查了大量OSA患者中可从全血细胞计数（CBC）谱得出的全身炎症标志物与睡眠参数之间的关联。
方法
2017年1月至2022年4月期间到我院耳鼻咽喉科睡眠诊所就诊的患者接受了多导睡眠图检查和包括CBC在内的常规实验室检查。分析了三种全身炎症标志物——全身免疫炎症指数（SII）、中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）——与多导睡眠图及人口统计学因素之间的关联，这些因素包括年龄、性别、体重指数、呼吸暂停低通气指数（AHI）、低通气指数（HI）、最低血氧饱和度（%）、匹兹堡睡眠质量指数（PSQI）、爱泼华嗜睡量表，以及非快速眼动（REM）睡眠3期、REM睡眠和打鼾时间的百分比。比较了OSA亚组之间的炎症标志物，并在不同OSA严重程度的亚组中分析了关联。
结果
共纳入1102例患者（968例男性和134例女性），其平均AHI为33.0±24.3。PSQI与SII显著相关（P=0.027）。未发现NLR或PLR的独立显著因素。在单纯打鼾和轻度OSA亚组中，未发现睡眠参数与SII之间存在显著关联。在重度OSA亚组中，AHI（P=0.004）和PSQI（P=0.012）与SII独立相关。
结论
我们的研究基于简单且相对经济高效的CBC分析了全身炎症标志物，结果表明AHI和SII仅在重度OSA亚组中显著相关。
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