The Monocyte/HDL Cholesterol Ratio in Obstructive Sleep Apnea Syndrome

Abstract

Objective: Obstructive sleep apnea syndrome (OSAS) is the most common condition among sleep-related respiratory disorders. The etiology is not clear. However, systemical and local inflammation in the respiratory tract of the patients has been acknowledged. Monocytes and macrophages play the critical role in the inflammation process. These cells participate in the release of the proinflammatory cytokines in inflammation sites. High-density lipoprotein (HDL) cholesterol is a molecule with an anti-inflammatory effect. Monocyte/HDL cholesterol ratio (MHR) is an inflammation marker being used recently. In our study, we aimed to compare inflammation marker levels between patients diagnosed with OSAS with subsequent polysomnography and the non OSAS group, determine the relationship between the severity of OSAS and MHR and, investigate the utility of the MHR for diagnosing OSAS. Materials and Methods: The data from the patients' files who had polysomnography due to OSAS symptoms in our unit between July 2017 and December 2017 have been retrospectively analyzed, and polysomnography results were recorded. Demographic data and the results of biochemistry and complete blood count (CBC) panels of patients with OSAS and who were not also were recorded. Results: Out of 147 patients who underwent polysomnography in the period identified, 104 were diagnosed with OSAS. Monocyte count and MHR values were significantly high (p<0,0001 in both) and HDL levels were significantly low (p=0,03) in OSAS group. There was also a moderately significant positive correlation between apnea-hypopnea index (AHI) and MHR (p<0,0001, r: 0,411). Conclusion: MHR may be a useful tool for diagnosing OSAS. Because of the positive correlation between MHR and AHI which represents the severity of the disease, MHR may be used for the classification of OSAS. Öz Amaç: Obstrüktif uyku apne sendromu (OSAS) uyku ile ilişkili solunum bozuklukları içerisinde en sık görülen hastalıktır. OSAS'ın etyolojisi kesin olarak bilinmemekle birlikte hastalarda sistemik ve havayolunda lokal inflamasyon varlığı gösterilmiştir. Monosit ve makrofajlar inflamasyonda rol alan önemli hücrelerdir. İnflamasyon bölgesinde proinflamatuar sitokinlerin salınmasında görev alırlar. Yüksek dansiteli lipoprotein (HDL) kolesterolü anti inflamatuar etkisi olan bir moleküldür. Monosit/HDL kolesterol oranı (MHO) yakın zamanda kullanılmaya başlanan bir inflamasyon belirtecidir. Çalışmamızda ünitemizde polisomnografi ile OSAS tanısı alanların ve almayanların Ad dress for Cor res pon den ce/Ya zış ma Ad re si: