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Xie W, Chen C, Li H, Tu Y, Zhong Y, Lin Z, Cai Z. Imidacloprid-induced lung injury in mice: Activation of the PI3K/AKT/NF-κB signaling pathway via TLR4 receptor engagement. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 931:172910. [PMID: 38701926 DOI: 10.1016/j.scitotenv.2024.172910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/19/2024] [Accepted: 04/29/2024] [Indexed: 05/05/2024]
Abstract
Significant impairment of pulmonary function has been demonstrated through long-term exposure to neonicotinoid insecticides, such as imidacloprid (IMI). However, the underlying mechanisms of lung injury induced by IMI remain unclear. In this study, a mouse model of IMI-induced pulmonary injury was established, and the toxicity and lung damage were assessed through mouse body weight, organ index, hematological parameters, and histopathological analysis of lung tissues. Furthermore, metabolomics and transcriptomics techniques were employed to explore the mechanistic aspects. Results from the toxicity assessments indicated that mouse body weight was significantly reduced by IMI, organ index was disturbed, and hematological parameters were disrupted, resulting in pulmonary injury. The mechanistic experimental results indicate that the differences in metabolites and gene expression in mouse lungs could be altered by IMI. Validation of the results through combined analysis of metabolomics and transcriptomics revealed that the mechanism by which IMI induces lung injury in mice might be associated with the activation of the TLR4 receptor, thereby activating the PI3K/AKT/NF-κB signaling pathway to induce inflammation in mouse lungs. This study provided valuable insights into the mechanisms underlying IMI-induced pulmonary damage, potentially contributing to the development of safer pest control strategies. The knowledge gained served as a robust scientific foundation for the prevention and treatment of IMI-related pulmonary injuries.
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Affiliation(s)
- Wen Xie
- Ministry of Education Key Laboratory of Analytical Science for Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Canrong Chen
- Ministry of Education Key Laboratory of Analytical Science for Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Heming Li
- Ministry of Education Key Laboratory of Analytical Science for Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Yuxin Tu
- Ministry of Education Key Laboratory of Analytical Science for Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Yanhui Zhong
- Ministry of Education Key Laboratory of Analytical Science for Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, China
| | - Zian Lin
- Ministry of Education Key Laboratory of Analytical Science for Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350108, China.
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, 224 Waterloo Road, Kowloon Tong, 999077, Hong Kong.
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Zeng J, He J, Chen M, Li J. Association between mean platelet volume and obstructive sleep apnea-hypopnea syndrome: A systemic review and meta-analysis. PLoS One 2024; 19:e0297815. [PMID: 38363791 PMCID: PMC10871486 DOI: 10.1371/journal.pone.0297815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/12/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Despite polysomnography (PSG) being acknowledged being considered the gold standard for diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS), researchers have been seeking a biomarker that is less invasive, more practical in detection, and cost-effective for diagnosing and assessing the severity of the disease. To address this concern, the values of mean platelet volume (MPV) between patients with OSAHS and healthy controls were compared, and the relationship between MPV and multiple sleep monitoring parameters was analyzed in this study. METHODS A comprehensive search was conducted across medical databases, including PubMed, Web of Science, EMBASE, CNKI, and Wanfang, up until August 2, 2023, to identify published articles related to OSAHS. This study reviewed the literature regarding the values of MPV in individuals with OSAHS and control groups, the Pearson/Spearman correlation coefficients between MPV and sleep monitoring parameters, and the odds ratios (OR) of MPV concerning the occurrence of cardiovascular diseases (CVDs) in patients with OSAHS. Meta-analyses were performed using standardized mean difference (SMD), Fisher's z values correlation coefficients (ZCOR) and odds ratio (OR) as effect variables. A fixed-effect model was used if the heterogeneity was not significant (I2<50%); otherwise, a random-effect model was applied. We will also combine the treatment effect estimates of individual trials using fixed-effect and random-effects models. Statistical analysis was carried out by employing STATA 11.0 and R 4.1.3. RESULTS In total, 31 articles were selected for the final analysis. The study involved 3604 patients and 1165 control individuals. The MPV in the OSAHS group was considerably elevated in comparison to the healthy controls (SMD = 0.37, 95%CI = 0.21-0.53, P < 0.001), particularly among individuals with severe OSAHS (SMD = 0.57, 95%CI = 0.23-0.90, P = 0.001). Subgroup analysis based on ethnicity, mean body mass index (BMI), and study design type also revealed a considerably higher MPV in the OSAHS category in comparison to the healthy controls. Furthermore, MPV showed correlations with various sleep monitoring parameters. The elevation of MPV may be one of the risk factors for CVDs in individuals with OSAHS (adjusted OR = 1.72, 95%CI = 1.08-2.73, P = 0.022). CONCLUSION MPV is a relatively simple, cost-effective, and practical indicator of the severity of OSAHS, with its values being linked to the risk of CVDs in individuals with OSAHS.
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Affiliation(s)
- Jun Zeng
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, Sichuan, China
| | - Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, Sichuan, China
| | - MeiFeng Chen
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, Sichuan, China
| | - Jia Li
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
- Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, Sichuan, China
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3
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Di Lorenzo B, Scala C, Mangoni AA, Zoroddu S, Paliogiannis P, Pirina P, Fois AG, Carru C, Zinellu A. A Systematic Review and Meta-Analysis of Mean Platelet Volume and Platelet Distribution Width in Patients with Obstructive Sleep Apnoea Syndrome. Biomedicines 2024; 12:270. [PMID: 38397872 PMCID: PMC10887137 DOI: 10.3390/biomedicines12020270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent yet underestimated disorder caused by the complete or partial obstruction of the upper airways. Although polysomnography is the gold standard for OSAS diagnosis, there is an active search for easily accessible biomarkers of disease presence and severity, particularly those reflecting morphological changes in specific blood cells. We investigated the associations between the presence and severity of OSAS, continuous positive airway pressure (CPAP) treatment, mean platelet volume (MPV), and platelet distribution width (PDW), routinely assessed as part of the complete blood count. From 262 retrieved records from PubMed, the Web of Science, Scopus, and Google Scholar, 31 manuscripts were selected for a final analysis, 30 investigating MPV and 15 investigating PDW. MPV was not statistically different between OSAS patients and healthy controls; however, it progressively increased with disease severity. By contrast, OSAS patients had significantly higher PDW values than controls (SMD = 0.40, 95% CI: 0.25 to 0.56; p ˂ 0.001), and the difference increased with disease severity. In a univariate meta-regression, there were significant associations between the MPV and publication year, the apnoea-hypopnea index, and diabetes mellitus, while no associations were observed with the PDW. No significant between-group differences were observed in the subgroup analyses. These data suggest that PDW, and to a lesser extent, MPV, are potential biomarkers of OSAS and require further research to ascertain their pathophysiological significance (PROSPERO, CRD42023459413).
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Affiliation(s)
- Biagio Di Lorenzo
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy (C.C.); (A.Z.)
| | - Chiara Scala
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy (P.P.)
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Arduino A. Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia
| | - Stefano Zoroddu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy (C.C.); (A.Z.)
| | - Panagiotis Paliogiannis
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy (P.P.)
| | - Pietro Pirina
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy (P.P.)
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Alessandro G. Fois
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy (P.P.)
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy (C.C.); (A.Z.)
- Quality Control Unit, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy (C.C.); (A.Z.)
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Lin CW, Lin PW, Chiu LW, Chai HT, Chang CT, Friedman M, Salapatas AM, Rahavi-Ezabadi S, Lin HC. Inflammatory biomarkers of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in 563 severe OSA patients before and after surgery. J Otolaryngol Head Neck Surg 2023; 52:49. [PMID: 37501207 PMCID: PMC10375829 DOI: 10.1186/s40463-023-00653-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Evidence has proved that high neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were risk factors for cardiovascular comorbidities. The alterations of NLR and PLR following obstructive sleep apnea (OSA) treatment were under studied and thus should be investigated. This study aimed to evaluate the changes of inflammatory biomarkers including NLR and PLR in severe OSA patients after surgical interventions of the upper airway, and their relationships with improvements in polysomnographic (PSG) parameters. METHODS This retrospective cohort study included 563 consecutive severe OSA patients at a tertiary academic medical center who received OSA surgery, as well as underwent pre- and post-operative polysomnographic (PSG) examinations and blood tests. The changes of major PSG estimates, NLR, and PLR before and at least 3 months after OSA surgery were analyzed using paired t-tests with subgroup analyses. Pearson's correlations were performed to discover which PSG parameter contributed to the improvement of the values. RESULTS After OSA surgery, the major PSG estimates, NLR and PLR dropped significantly in the overall population. In those with a higher preoperative NLR (pre-operative NLR≧3) and PLR (pre-operative PLR≧150), the mean (SD) difference of NLR (- 0.8 [1.6], 95% CI - 1.5 to - 0.2) and PLR (- 41.6 [40], 95% CI - 52.8 to - 30.5) were even more substantial. The changes of the "apnea, longest (r = 0.298, P = .037)" and "hypopnea, longest (r = 0.321, P = .026)" were found significantly related to the improvement of PLR. CONCLUSION NLR and PLR did significantly drop in severe OSA patients following OSA surgery, and this could be related to the alterations of sleep indices. The findings could possess clinical importance for severe OSA patients after OSA surgeries in reducing possible OSA-associated cardiovascular comorbidities.
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Affiliation(s)
- Chung-Wei Lin
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Pei-Wen Lin
- Division of Glaucoma, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Li-Wen Chiu
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Han-Tan Chai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chun-Tuan Chang
- Department of Business Management, Institute of Healthcare Management, Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Michael Friedman
- Department of Otolaryngology, Division of Sleep Surgery, Rush University Medical Center, Chicago, IL, USA
- Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Anna M Salapatas
- Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
| | - Sara Rahavi-Ezabadi
- Otorhinolaryngology Head and Neck Surgery Department, Otorhinolaryngology Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hsin-Ching Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Business Management, Institute of Healthcare Management, Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- Department of Otolaryngology, Robotic Surgery Center and Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Rd., Niao-Sung District, Kaohsiung, 833, Taiwan.
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Pau MC, Zinellu A, Mangoni AA, Paliogiannis P, Lacana MR, Fois SS, Mellino S, Fois AG, Carru C, Zinellu E, Pirina P. Evaluation of Inflammation and Oxidative Stress Markers in Patients with Obstructive Sleep Apnea (OSA). J Clin Med 2023; 12:3935. [PMID: 37373630 DOI: 10.3390/jcm12123935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Background: The identification of circulating markers of oxidative stress and systemic inflammation might enhance risk stratification in obstructive sleep apnea (OSA). We investigated the association between specific haematological parameters, as easily measurable markers of oxidative stress and inflammation, and the degree of hypoxia during polysomnography using the apnea hypopnea index (AHI), oxygen desaturation index (ODI), and oxygen saturation (SpO2), in OSA patients. Methods: Associations between polysomnographic parameters and demographic, clinical, and laboratory characteristics were assessed in a consecutive series of patients with OSA attending the Respiratory Disease Unit of the University Hospital of Sassari, north Sardinia (Italy), between 2015 and 2019. Results: In 259 OSA patients (195 males and 64 females), the body mass index (BMI) was significantly and positively associated with the AHI and ODI, and negatively associated with the mean SpO2. No haematological parameter was independently associated with the AHI or ODI. By contrast, albumin, neutrophil, and monocyte counts, and the systemic inflammatory response index (SIRI) were independently associated with a lower SpO2. Conclusions: Our results suggest that albumin and specific haematological parameters are promising markers of reduced oxygen saturation in OSA.
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Affiliation(s)
- Maria Carmina Pau
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia
- Department of Cliical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia
| | | | - Maria Roberta Lacana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Sara Solveig Fois
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Sabrina Mellino
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Alessandro G Fois
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
- Quality Control Unit, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Elisabetta Zinellu
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Pietro Pirina
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
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Di Lorenzo B, Pau MC, Zinellu E, Mangoni AA, Paliogiannis P, Pirina P, Fois AG, Carru C, Zinellu A. Association between Red Blood Cell Distribution Width and Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12093302. [PMID: 37176740 PMCID: PMC10179738 DOI: 10.3390/jcm12093302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, p < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO2) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047).
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Affiliation(s)
- Biagio Di Lorenzo
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Maria Carmina Pau
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Elisabetta Zinellu
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedfor Park, SA 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia
| | | | - Pietro Pirina
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Alessandro G Fois
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
- Quality Control Unit, University Hospital of Sassari (AOU), 07100 Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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Li K, Zhuo Y, He Y, Lei F, He P, Lang Q, He D, Zuo S, Chen S, Yang X, Wen X, Zhang Z, Liu C. T cell receptor repertoire as a novel indicator for identification and immune surveillance of patients with severe obstructive sleep apnea. PeerJ 2023; 11:e15009. [PMID: 37051415 PMCID: PMC10084822 DOI: 10.7717/peerj.15009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/15/2023] [Indexed: 04/14/2023] Open
Abstract
Background Obstructive sleep apnea (OSA) is the most prevalent sleep disturbance that affects approximately 936 million people worldwide and leads to extensively increased incidence of cardiovascular disease, metabolic syndrome, neurological disorders, and traffic accidents. Severe OSA patients suffer a significantly higher risk of complications and worse comorbidity outcomes. Notwithstanding, with inadequate access to contact diagnosis based on polysomnography (PSG), numerous patients with severe sleep apnea have not been diagnosed, especially during the pandemic. Moreover, how the T cell immunity is impaired in OSA remains largely unknown. Methods We primarily investigated the T cell receptor (TCR) repertoires of 50 patients with severe OSA, 23 patients with mild-to-moderate OSA, 23 patients without OSA, and 157 healthy individuals, from their peripheral blood. Firstly, we compared the clinical characteristics, blood cell counts, the ratio of neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and CD4+/CD8+T cell count between groups. Then, we compared the diversity, clonotypes, unique VJ alleles in patients with different disease severity. Furthermore, by identifying a series of disease-associated amino acid sequences, we employed a repeated hold-out machine learning strategy to explore the optimal algorithm for calculating the TCR repertoire characteristic Index (OSA-TCI). We further confirmed its relation with clinical features by linear regression analysis. Moreover, in followup of severe OSA patients who accepted adherent non-invasive ventilation, we assessed the changes of TCR repertoires, OSA-TCI, ESS, NLR, PLR, and CD4+/CD8+T after therapy. Results We found an unexpected increase in diversity and clonotypes in the TCR repertoire of OSA patients. Furthermore, we successfully developed a novel indicator termed OSA-TCI to summarize the unique repertoire alteration, which provided 90% of sensitivity and 87% of specificity in distinguishing severe OSA. In rationalization, OSA-TCI was found correlated to AHI, BMI, hemoglobin, N1, N2 percentage of sleep, snoring, smoking and lowest oxygen saturation, but only independently related to AHI (R = 0.603) and smoking (R = 0.22). Finally, we observed OSA-TCI in the eight severe patients decreased significantly after home noninvasive ventilation for three months during follow-up, consistently in line with the TCR repertoire improvement. In contrast, NLR, PLR, and the ratio of CD4+/CD8+T cell count were found useless to diagnose and therapeutic surveillance of severe OSA. Conclusions Our study is the first to unveil the TCR repertoire alteration in OSA, indicates possible insidious autoimmune mechanisms underlying OSA, and suggests that TCR repertoires serve as a convenient peripheral blood biomarker for OSA assessment without long-time contact and facility/instrument occupation. It may shed light on future diagnostic, immunological, pathophysiological, and prognostic research on OSA.
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Affiliation(s)
- Kai Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, The Third People’s Hospital of Chengdu, Southwest Jiaotong University, Chengdu, China
- Department of Respiratory Medicine, The People’s Hospital of Pujiang County, Chengdu, China
| | - Yue Zhuo
- Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yue He
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Lei
- Sleep Medicine Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Pengming He
- Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Lang
- Department of Pulmonary Diseases and Critical Care, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Dingxiu He
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Emergency Medicine, The People’s Hospital of Deyang, Deyang, China
| | - Suni Zuo
- Department of Respiratory Medicine, The People’s Hospital of Pujiang County, Chengdu, China
| | - Shan Chen
- Department of Respiratory and Critical Care Medicine, The Third People’s Hospital of Chengdu, Southwest Jiaotong University, Chengdu, China
| | - Xin Yang
- Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xueping Wen
- Chengdu ExAb Biotechnology LTD, Chengdu, China
| | - Zhixin Zhang
- Department of Health Management & Institute of Health Management, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chengdu ExAb Biotechnology LTD, Chengdu, China
| | - Chuntao Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
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8
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Silva R, Brito TP, Wanderley AC, Frota RB, Melo JC. Major risk factors for obstructive sleep apnea monitored in the home. A cross-sectional study. SAO PAULO MED J 2021; 139:643-647. [PMID: 34730754 PMCID: PMC9634830 DOI: 10.1590/1516-3180.2020.0689.r1.22042021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is characterized by recurrent pharyngeal wall collapse during sleep caused by anatomical or functional changes associated with obesity or dislocation of maxillofacial structures. OBJECTIVE To determine the major risk factors for obstructive sleep apnea monitored in the home. DESIGN AND SETTING Cross-sectional study conducted in a private clinic in Fortaleza (CE), Brazil. METHODS Between 2015 and 2018, 427 patients were screened for OSA with home-based monitoring, yielding 374 positives. Information was collected on age, sex, body mass index (BMI), hypertension, diabetes (DM), dyslipidemia, coronary artery disease (CAD), arrhythmia, peripheral artery occlusive disease (PAOD), heart failure (HF) and lung disease. The home sleep apnea test result was then compared with the clinical diagnosis. Lastly, parameters identified as significant in the univariate analysis were subjected to multivariate logistic regression. RESULTS Male sex predominated, although not significantly. OSA was associated with hypertension, DM, dyslipidemia, age and BMI. The risk of OSA being associated with these parameters was 2.195 (hypertension), 11.14 (DM), 2.044 (dyslipidemia) and 5.71 (BMI). The association was also significant for BMI categories (normal, overweight or obese). No significant association was observed for CAD, arrhythmia, PAOD, HF or lung disease. After multivariate logistic analysis, only age and BMI (and its categories) remained significant. CONCLUSION OSA was associated with hypertension, DM, dyslipidemia, age and BMI in univariate analyses, but only with age and BMI (and its categories) in multivariate logistic analysis.
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Affiliation(s)
- Ricardo Silva
- MD. Full Professor, Department of Cardiology, School of Medicine, Universidade Federal do Ceará (UFCE), Fortaleza (CE), Brazil.
| | - Tharcisio Pereira Brito
- MD. Postgraduate Student, Department of Cardiology, School of Medicine, Universidade Federal do Ceará (UFC), Fortaleza (CE), Brazil.
| | - Antônio Cavalcanti Wanderley
- MD. Postgraduate Student, Department of Cardiology, School of Medicine, Universidade Federal do Ceará (UFC), Fortaleza (CE), Brazil.
| | | | - João Cateb Melo
- MD. Attending Physician, Clínica Cateb Melo, Fortaleza (CE), Brazil.
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9
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Morell-Garcia D, Toledo-Pons N, Sanchis P, Bauça JM, Sánchez JM, Peña-Zarza J, Giménez P, Pierola J, de la Peña-Bravo M, Alonso-Fernández A, Barceló A. Red cell distribution width: a new tool for the severity prediction of sleep apnoea syndrome in children. ERJ Open Res 2020; 6:00278-2019. [PMID: 33043053 PMCID: PMC7533379 DOI: 10.1183/23120541.00278-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 06/10/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction Red 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. Methods An 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. Results A 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. Conclusions In 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. Red cell distribution width and mean corpuscular haemoglobin concentration are blood markers associated with the severity of paediatric OSAhttps://bit.ly/2Asw1xa
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Affiliation(s)
- Daniel Morell-Garcia
- Dept of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain
| | - Núria Toledo-Pons
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain.,Respiratory Dept, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Pilar Sanchis
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain
| | - Josep Miquel Bauça
- Dept of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain
| | - José María Sánchez
- Haematology Dept, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - José Peña-Zarza
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain.,Pulmonology and Sleep Disorders Section, Dept of Pediatrics, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Paloma Giménez
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain
| | - Javier Pierola
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain
| | - Mónica de la Peña-Bravo
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain.,Respiratory Dept, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Alberto Alonso-Fernández
- Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain.,Respiratory Dept, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Antònia Barceló
- Dept of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de les Illes Balears, Palma de Mallorca, Spain
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10
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Liu C, Wang H, Zhu C, Wang S. Plasma expression of HIF-1α as novel biomarker for the diagnosis of obstructive sleep apnea-hypopnea syndrome. J Clin Lab Anal 2020; 34:e23545. [PMID: 32896931 PMCID: PMC7755787 DOI: 10.1002/jcla.23545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background Obstructive sleep apnea‐hypopnea syndrome (OSAHS) is a common breathing disorder during sleep with potential lethality and multi‐complications. Polysomnography (PSG) is now the golden standard for the diagnosis obstructive sleep apnea‐hypopnea syndrome. However, PSG is expensive and time‐consuming. Therefore, it is important to find inexpensive and convenient biomarkers for the diagnosis of OSAHS. Objective The present study aimed to explore the potential diagnostic value of HIF‐1α for OSAHS and its clinical significance. Methods This study consisted of 368 patients admitted to the sleep laboratory. The patients were classified according to their apnea‐hypopnea index (AHI) scores as OSA negative (AHI < 5), mild‐moderate (AHI:5‐30), and severe OSA (AHI > 30), and severe OSA treated with continuous positive airway pressure (CPAP). qRT‐PCR was used to detect mRNA levels in the plasma; Pearson's correlation analysis was performed to analyze the correlation of HIF‐1α mRNA level and the clinicopathological factors of OSAHS; ROC curve was constructed to evaluate the diagnostic value of HIF‐1α mRNA. Results HIF‐1α mRNA was significantly up‐regulated in the plasma of OSAHS patients, especially patients with severe OSAHS. HIF‐1α mRNA was positively correlated with the AHI and ODI but negatively correlated with the mean oxygen saturation in patients with OSAHS. Results of ROC curve showed that HIF‐1α is a sensitive biomarker for the diagnosis of OSAHS, especially severe OSAHS. Conclusions HIF‐1α mRNA might be used as s a convenient and inexpensive method for triaging OSAHS patients PSG assessment in the hospital and evaluate the curative effect.
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Affiliation(s)
- Caidong Liu
- Department of Laboratory MedicineNanjing First HospitalNanjing Medical UniversityNanjingChina
| | - Haoyu Wang
- Department of Biochemistry and Molecular BiologyNanjing Medical UniversityNanjingChina
| | - Chenbin Zhu
- Department of Laboratory MedicineNanjing First HospitalNanjing Medical UniversityNanjingChina
| | - Shukui Wang
- Department of Laboratory MedicineNanjing First HospitalNanjing Medical UniversityNanjingChina
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11
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Association between the neutrophil-to-lymphocyte ratio and obstructive sleep apnea: a meta-analysis. Sci Rep 2020; 10:10862. [PMID: 32616762 PMCID: PMC7331605 DOI: 10.1038/s41598-020-67708-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 06/11/2020] [Indexed: 01/05/2023] Open
Abstract
This meta-analysis is aimed to investigate the association between the neutrophil-to-lymphocyte ratio (NLR) and obstructive sleep apnea (OSA). The PubMed, Web of Science, Google Scholar, and Cochrane Library databases were searched to collect all relevant articles. The pooled standardized mean difference (SMD) with a 95% confidence interval (CI) was calculated using the random effects model. In addition, subgroup analysis and meta-regression analysis were performed. Eleven eligible articles containing 2,259 patients with OSA were included in this study. Pooled outcomes revealed that the NLR was significantly higher in patients with OSA than in controls (SMD 0.62, 95% CI 0.29–0.94, P = 0.002). In subgroup analyses, differences in the NLR between patients and controls increased with worsening OSA grades. Furthermore, meta-regression analysis showed that differences in mean BMI exerted a significant effect on differences in the NLR (P = 0.0003). In summary, our meta-analysis demonstrated that the NLR in OSA patients was significantly higher than that in controls, and the difference was larger in patients with severe OSA. These results indicate that the NLR may be a reliable marker for detecting systemic inflammation and predicting disease severity in patients with OSA.
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12
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Wu S, Gao Y, Qian X, Zhao L, Xu H, Xu W, Kong X, Yang Y, Che H, Wang Y, Yuan X, Liu L. [Correlation between severity of obstructive sleep apnea syndrome and red cell distribution width in elderly patients]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:703-707. [PMID: 32897199 DOI: 10.12122/j.issn.1673-4254.2020.05.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the correlation between the severity of obstructive sleep apnea syndrome (OSAS) and red cell distribution width (RDW) in elderly patients. METHODS A cross-sectional study was conducted among 311 elderly patients diagnosed with OSAS in the snoring clinic between January, 2015 and October, 2016 and 120 healthy controls without OSAS from physical examination populations in the General Hospital of PLA. The subjects were divided into control group with apnea-hypopnea index (AHI) <5 (n=120), mild OSAS group (AHI of 5.0-14.9; n=90), moderate OSAS group (AHI of 15.0-29.9; n=113) and severe OSAS group (AHI ≥ 30; n=108). The clinical characteristics and the results of polysomnography, routine blood tests and biochemical tests of the subjects were collected. Multiple linear regression analysis was used to examine the correlation between OSAS severity and RDW. RESULTS The levels of RDW and triglyceride were significantly higher in severe OSAS group than in the other groups (P < 0.01). The levels of fasting blood glucose and body mass index were significantly higher in severe and moderate OSAS groups than in mild OSAS group and control group (P < 0.05 or P < 0.01). Multiple linear regression analysis showed that AHI was positively correlated with body mass index (β=0.111, P=0.032) and RDW (β=0.106, P=0.029). The area under ROC curve of RDW for predicting the severity of OSAS was 0.687 (P=0.0001). CONCLUSIONS The RDW increases as OSAS worsens and may serve as a potential marker for evaluating the severity of OSAS.
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Affiliation(s)
- Shuping Wu
- Department of Respiratory Disease, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing 102206, China
| | - Xiaoshun Qian
- Department of Respiratory Disease, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Libo Zhao
- Department of Geriatric Cardiology, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Hu Xu
- Department of Geriatric Cardiology, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Weihao Xu
- Department of Geriatric Cardiology, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Xiaoxuan Kong
- Department of Geriatric Cardiology, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Yang Yang
- Department of Respiratory Disease, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Hebin Che
- Big Data Center, General Hospital of PLA, Beijing 100853, China
| | - YaBin Wang
- National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Xina Yuan
- Department of Respiratory Disease, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
| | - Lin Liu
- Department of Respiratory Disease, Second Medical Center of General Hospital of PLA, Beijing 100853, China.,National Clinical Research Center for Geriatric Diseases, General Hospital of PLA, Beijing 100853, China
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13
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Koseoglu S, Unal Y, Saruhan E, Bek V, Kutlu G. The role of the lymphocyte-to-C-reactive protein ratio in obstructive sleep apnea. NEUROL SCI NEUROPHYS 2020. [DOI: 10.4103/nsn.nsn_24_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Li N, Ren L, Wang JH, Yan YR, Lin YN, Li QY. Relationship between monocyte to HDL cholesterol ratio and concomitant cardiovascular disease in Chinese Han patients with obstructive sleep apnea. Cardiovasc Diagn Ther 2019; 9:362-370. [PMID: 31555541 DOI: 10.21037/cdt.2019.08.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular disease (CVD), which is attributed to chronic intermittent hypoxia (CIH) induced inflammation. As a new inflammatory biomarker of CVD, monocyte to high-density lipoprotein cholesterol ratio (MHR) has received little attention in OSA studies to date. Therefore, we aimed to investigate the correlation between MHR and concomitant CVD in Chinese Han patients with OSA. Methods A total of 657 Chinese Han subjects (169 controls, 145 mild, 94 moderate, and 249 severe OSA) of both genders were enrolled in this cross-sectional study, with an average BMI of 32.35±6.56 kg/m2. The relationship between MHR and concomitant CVD in OSA patients was analyzed. Results The level of MHR was correlated positively with apnea-hypopnea index (AHI), while negatively with lowest SpO2 (P<0.01). Moreover, the MHR values were higher in OSA patients with CVD than those without CVD (17.64±7.16 vs. 12.73±5.06, P<0.001). Logistic regression analysis demonstrated that MHR is an independent predictor of CVD (OR =1.190, P<0.001). The ROC analysis indicated that the best cut-off value of MHR for predicting CVD in OSA patients was 15.364 (sensitivity 65.0%, specificity 74.4%), while its cutoff value for identifying CVD in severe OSA patients was 15.362 (sensitivity 67.3%, specificity 80.1%). Conclusions MHR is strongly correlated with the severity of OSA and the occurrence of CVD in OSA patients. As an easy and available test, MHR is expected to be a promising biomarker candidate in predicting CVD in Chinese Han patients with OSA.
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Affiliation(s)
- Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Lei Ren
- Department of Respiratory Rehabilitation, The Fourth Rehabilitation Hospital of Shanghai (Shanghai Jing'an Geriatric Hospital), Shanghai 200042, China
| | - Jia Hui Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ya Ru Yan
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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García-Ortega A, Mañas E, López-Reyes R, Selma MJ, García-Sánchez A, Oscullo G, Jiménez D, Martínez-García M. Obstructive sleep apnoea and venous thromboembolism: pathophysiological links and clinical implications. Eur Respir J 2019; 53:13993003.00893-2018. [PMID: 30385528 DOI: 10.1183/13993003.00893-2018] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 10/12/2018] [Indexed: 12/13/2022]
Abstract
Obstructive sleep apnoea (OSA) and pulmonary embolism (PE) remain major health issues worldwide. Data from pathophysiological studies suggest that both intermittent hypoxia and sleep fragmentation are associated with increased blood coagulability, endothelial dysfunction and venous stasis. There is growing evidence that OSA is potentially prevalent in and a risk factor for PE. Conversely, patients with acute PE have two to four times greater risk of moderate-to-severe OSA. The role of continuous positive airway pressure (CPAP) treatment in improving clinically meaningful outcomes in PE patients remains unclear, although some authors have suggested that CPAP could improve the hypercoagulability state and normalise circadian alterations in some of the coagulation molecules, as observed in patients with OSA. Emerging research highlights the complex interdependent relationships between OSA and PE, emphasising the need for rigorous, well-powered trials that address the impact of OSA and its treatment on the prevention and management of PE. Undoubtedly, these will require closer collaboration between the sleep medicine and clinical/venous thromboembolism communities.
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16
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Correlation of changes in the red blood cell distribution width with the response to continuous positive airway pressure in patients with obstructive sleep apnea. Sleep Biol Rhythms 2018. [DOI: 10.1007/s41105-018-0191-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dennis JA, Alazzeh A, Kumfer AM, McDonald-Thomas R, Peiris AN. The Association of Unreported Sleep Disturbances and Systemic Inflammation: Findings from the 2005-2008 NHANES. SLEEP DISORDERS 2018; 2018:5987064. [PMID: 30402295 PMCID: PMC6198565 DOI: 10.1155/2018/5987064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/15/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVE Sleep apnea is associated with elevated inflammatory markers. A subgroup of patients never report sleep disturbances to their physician. The inflammatory status of this subgroup is not known. The present study aims to evaluate two inflammatory markers, C-reactive protein (CRP) and red cell distribution width (RDW), in those with unreported sleep disturbances and compares these findings to those with and without reported sleep disorders. We also investigate the utility of RDW as an inflammatory marker in sleep disorders. METHODS Sample includes 9,901 noninstitutionalized, civilian, nonpregnant adults from the 2005-2008 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional U.S. study. Sleep questionnaire and laboratory data were used to compare inflammatory markers (CRP and RDW) in five subgroups of individuals: reporting physician-diagnosed sleep apnea, reporting another physician-diagnosed sleep disorder, reported sleep disturbance to physician with no resulting diagnosis, unreported sleep disturbance (poor sleep quality not reported to physician), and no diagnosed sleep disorder or sleep disturbance. RESULTS Individuals with unreported sleep disturbance had significantly higher odds of elevated RDW (>13.6%) when compared to those without a sleep disturbance in adjusted models (OR=1.33). Those with unreported sleep disturbance had significantly higher odds of elevated CRP levels (>1 mg/L) than those without sleep disturbances (OR 1.34), although the association was not significant when adjusted for obesity and other controls. CONCLUSION Self-identified unreported sleep disturbances are associated with significantly higher odds of elevated RDW than those without sleep disturbances. RDW may serve as a valuable indicator in identifying individuals at higher risk for sleep apnea and other sleep disorders.
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Affiliation(s)
- Jeff A. Dennis
- Department of Public Health, Texas Tech University Health Sciences Center, 3601 4th St., MS 9430, Lubbock, TX 79430, USA
| | - Ahmad Alazzeh
- Department of Pulmonary and Critical Care, East Tennessee State University, Quillen College of Medicine, VA Bldg. 1, Johnson City, TN 37614-0622, USA
| | - Ann Marie Kumfer
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., MS 9410, Lubbock, TX 79430, USA
| | - Rebecca McDonald-Thomas
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., MS 9410, Lubbock, TX 79430, USA
| | - Alan N. Peiris
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 3601 4th St., MS 9410, Lubbock, TX 79430, USA
- Clinical Research Institute, Texas Tech University Health Sciences Center, 3601 4th St., MS 8183, Lubbock, TX 79430, USA
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18
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Fan Z, Lu X, Long H, Li T, Zhang Y. The association of hemocyte profile and obstructive sleep apnea. J Clin Lab Anal 2018; 33:e22680. [PMID: 30246267 DOI: 10.1002/jcla.22680] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/20/2018] [Accepted: 08/27/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The hemocyte profile is one of the most frequently requested clinical laboratory tests. However, the analysis of blood cell indexes of obstructive sleep apnea (OSA) patients in previous studies was not comprehensive. And, this study aimed to fully analyze the blood routine in OSA patients. METHODS A retrospective study was conducted on 1087 male patients, who were admitted to the sleep center of Nanfang Hospital from May 2013 to February 2018. According to the apnea hypopnea index (AHI), patients were divided into four groups: control group (AHI < 5, n = 135), mild OSA (5 ≦ AHI < 15, n = 185), moderate OSA (15 ≦ AHI < 30, n = 171), and severe OSA (AHI ≧ 30, n = 596). Data collected included sleep parameters, complete blood routine, body mass index (BMI), age, and comorbidities. RESULTS In our study, leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, erythrocytes, hemoglobin, hematocrit, platelets, MPV, and PDW-SD were statistically significant among the four groups based on AHI (P < 0.05), but no significant differences were found in MCV, RDW-SD, N/L, and P/L ratio (P > 0.05). Neutrophils, lymphocytes, monocytes, eosinophils, basophils, hemoglobin, hematocrit, platelets, and MPV were significantly correlated with AHI. Moreover, multiple linear regression analysis demonstrated that hematocrit (β = 73.254, P = 0.001), neutrophils (β = 1.414, P = 0.012), and lymphocytes (β = 4.228, P < 0.001) were independently associated with AHI. CONCLUSION Neutrophils, lymphocytes, and hematocrit were independently associated with OSA severity. And combining these three blood cell indicators could contribute to the diagnosis of OSA.
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Affiliation(s)
- Zeqin Fan
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoxia Lu
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hong Long
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Taoping Li
- Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanhong Zhang
- Health Care Center, Guangdong Entry-exit Inspection and Quarantine Bureau, Guangzhou, China
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Kıvanc T, Kulaksızoglu S, Lakadamyalı H, Eyuboglu F. Importance of laboratory parameters in patients with obstructive sleep apnea and their relationship with cardiovascular diseases. J Clin Lab Anal 2017; 32. [PMID: 28345811 DOI: 10.1002/jcla.22199] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 02/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ostructive sleep apnea (OSA) is an independent risk factor for the development of cardiovascular events. Platelet activation and inflammation are the mechanisms involved in the association between OSA and cardiovascular disease (CVD). The markers of platelet activation and inflammation are the mean platelet volume (MPV), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), neutrophil- lymphocyte ratio (NLR). We aimed to define the association of NLR, PLR, RDW, and MPV with the severity of disease and the presence of CVD. METHODS This study consisted of 300 patients who were admitted to the sleep laboratory. The patients were classified according to their apnea- hypopnea index (AHI) scores as OSA negative (Group A: AHI<5), mild (Group B: AHI: 5-15), moderate (Group C: AHI=15-30), and severe OSA (Group D: AHI >30). RESULTS There were no significant differences in the NLR, PLR, and MPV among the groups (P>.05); only RDW differed significantly (P=.04). RDW was significantly higher in patients with than without risk factors for CVD [15.6% (15.4-15.7) vs 15.3% (15.1-15.3), respectively; P=.02]. CONCLUSIONS NLR, PLR, MPV, and RDW are widely available and easily obtained from a routinely performed hemogram. Among these laboratory parameters, only RDW can demonstrate the reverse consequences of OSA-associated comorbidities, because vascular damage due to systemic inflammation is an important underlying mechanism in these diseases. RDW might be used as a marker of the response and patient compliance with continuous positive airway pressure treatment.
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Affiliation(s)
- Tulay Kıvanc
- Department of Pulmonary Diseases, Başkent University School of Medicine, Konya, Turkey
| | - Sevsen Kulaksızoglu
- Department of Biochemistry, Başkent University School of Medicine, Konya, Turkey
| | - Huseyin Lakadamyalı
- Department of Pulmonary Diseases, Başkent University School of Medicine, Alanya, Turkey
| | - Fusun Eyuboglu
- Department of Pulmonary Diseases, Başkent University School of Medicine, Ankara, Turkey
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