Red cell distribution width: a new tool for the severity prediction of sleep apnoea syndrome in children

Abstract

IntroductionRed cell distribution width (RDW) is a parameter included in the complete blood count which informs about the size of the circulating red blood cell population and its distribution. In adults, an increase in RDW was shown to be associated both with obstructive sleep apnoea (OSA) and with an increase in cardiovascular mortality. The aim of this study was to determine whether RDW is a potential biomarker for screening children with moderate–severe OSA.MethodsAn observational study in snoring patients was performed. All patients underwent a sleep study and were classified either as simple snorers (apnoea–hypopnoea index (AHI) <1 event·h−1) or as patients with OSA (mild AHI ≥1 to <5 events·h−1; moderate–severe AHI ≥5 events·h−1). Blood analyses (complete blood count and C-reactive protein) were performed for every individual.ResultsA total of 175 individuals were recruited. The mean age was 8.3±3.6 years. Correlation studies between RDW and several sleep-related parameters showed negative significant associations with minimum oxygen saturation, and positive significant associations with oxygen desaturation index (≥3% and ≥4%), AHI and the arousal index. A predictive model for paediatric severe OSA (AHI ≥5 events·h−1) was found based on mean corpuscular haemoglobin concentration (MCHC) <34.9 g·dL−1 and RDW >13.1% values, adjusting for body mass index z-score and age (area under the curve 0.657; p=0.004). In addition, differences were found in eosinophil count and C-reactive protein concentrations among the three subgroups.ConclusionsIn children, RDW stands out as a biomarker associated with the severity of OSA. The use of RDW and MCHC could be a simple but useful tool for the severity prediction of paediatric OSA in snoring patients.

Selected routine laboratory tests in the clinical assessment of patients with obstructive sleep apnea

“…There are only a few data sources which describe the dependence between OSA severity and such parameters as MCV, MCH, or MCHC. There is also a possible influence of other medical conditions which have an impact on red blood cell parameters, such as alcohol intake, and vitamin deficiency [22]. Morell-Garcia et al reported that parameters such as MCHC significantly differed between moderate and severe OSA groups; thus, this parameter could be used as a marker of severe OSA [23].…”

AI-Enhanced Blood Cell Recognition and Analysis: Advancing Traditional Microscopy with the Web-Based Platform IKOSA

“…On the other hand, high-throughput methods, such as flow cytometry, which have the required quantitative power, lack morphological information [13,16]. It seems evident that multidimensional quantifications of cellular morphology bear a great potential for precision diagnostics [12,15,17,[50][51][52][53][54][55][56]. Up to now, quantitative morphological assessments of leukocytes have mainly focused on neutrophils and lymphocytes, the more abundant immune cell types [15,16,19,20,[57][58][59][60][61][62], while less common cells, like eosinophils, are hardly analyzed in these correlative analyses.…”