The association of neutrophil to lymphocyte ratio with presence and severity of obstructive sleep apnea

Abstract

BACKGROUND: Obstructive sleep apnea (OSA) is characterized by reductions in breathing amplitude during sleep caused by an obstructed or collapsed upper airway. The neutrophil to lymphocyte ratio (NLR) has been proposed as a novel biomarker for systemic infl ammatory response. The aim of the present study was to evaluate the relationship between NLR and OSA. METHODS: The study population consisted of 195 consecutive patients with clinical suspicion of OSA. Full night polysomnography was performed for all patients. Patients with an apnea hypopnea index (AHI) ≥ 5 were considered to have OSA. NLR was calculated as the ratio of neutrophil count to lymphocyte count. RESULTS: While 130 patients (91 male, mean age: 49.9±9.8 years) had OSA, 65 patients (42 male, mean age: 48.7 ± 10.2 years) had normal fi ndings according to AHI scores. Cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking were more common in patients with OSA. Patients with OSA had signifi cantly higher NLR than controls (1.87±0.80 vs 1.49±0.48, p=0.005). AHI score was signifi cantly correlated with NLR (r=0.228, p=0.001). NLR and presence of hyperlipidemia were independent predictors of OSA (OR: 2.451, 2.850, p=0.001, 0.004, respectively). NLR of 1.62 or higher predicted OSA with a sensitivity of 56.2 % and specifi city of 63.1 %. CONCLUSIONS: NLR was higher and also correlated with AHI score in patients with OSA which has not been reported previously. NLR more than 1.62 was an independent predictor of OSA. A simple, cheap white blood cell count may also give an idea about the presence and severity of OSA (Tab. 3, Fig. 3, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: infl ammation, cardiovascular risk, neutrophil to lymphocyte ratio, obstructive sleep apnea.

Association between obstructive sleep apnea and alcohol, caffeine and tobacco: A meta‐analysis

“…Out of the included studies, the mean age for the samples ranged from 38.5 to 66 on OSA group, and 42.9 to 66 controls. Diagnostic methods we used for evaluating tobacco, alcohol and caffeine in the studies were questionnaire, and in other not report studies . Each study used specific AHI values for OSA definition through PSG.…”

“…It is worth noting that the question “was the follow‐up carried out over a sufficient time period?” was considered not applicable for the included studies, since none of them proposed longitudinal results. Of the 11 studies included had moderate risk of bias, and 2 as low risk of bias . Decisions regarding individual domains within the ‘Risk of bias’ tool were observed in Figure .…”

After obstructive sleep apnea syndrome surgery, preoperative, postoperative early and late change of neutrophil / lymphocyte ratio, platelet / lymphocyte ratio and mean platelet volume

“…Platelet activation plays a role in inflammatory process upregulation by interacting with leukocytes as well as endothelial adhesion and aggregation [21] Inflammatory markers related to the severity of the disease In our study, NLR PLR and MPV were found to be comparable between the mild and moderate OSAS patients' group and the severe patients' group. It has been reported that NLR can give an idea about the presence and severity of OSAS [22]. In a study conducted by Sünbül et al [22] 130 OSAS patients and 65 healthy subjects were compared and NLR was found significantly higher than healthy subjects.…”

“…It has been reported that NLR can give an idea about the presence and severity of OSAS [22]. In a study conducted by Sünbül et al [22] 130 OSAS patients and 65 healthy subjects were compared and NLR was found significantly higher than healthy subjects. In addition, it was stated that AHI score and NLR values showed a significant correlation.…”

“…A total of 148 patients (22 In the normality test, the Shapiro Wilks test was used when the number of samples in the group was less than 50, and the Kolmogorov-Smirnov test was used when it was large. The Mann-Whitney U test was used when the difference between the two groups was not in normal distribution, and the Student t test was used when there was difference between the 2 groups.…”