1
|
Martelli V, Carelli E, Tomlinson GA, Orchanian-Cheff A, Kuo KHM, Lyons OD, Ryan CM. Prevalence of elevated hemoglobin and hematocrit levels in patients with obstructive sleep apnea and the impact of treatment with continuous positive airway pressure: a meta-analysis. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:889-901. [PMID: 35962574 DOI: 10.1080/16078454.2022.2109346] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is reported to be a cause of secondary polycythemia. The present study (i) reviewed the literature reporting the prevalence of secondary polycythemia in patients with OSA and (ii) determined the effect of continuous positive airway pressure (CPAP) therapy on hemoglobin and hematocrit levels in patients with OSA. METHODS We searched MEDLINE, Embase and Cochrane for studies of adult patients with OSA that reported hemoglobin and/or hematocrit levels. We performed summary estimates of (i) polycythemia prevalence and a subgroup analysis according to OSA severity, and (ii) change in hemoglobin and hematocrit levels following treatment with CPAP. RESULTS Synthesis of seven studies including 3,654 patients revealed an overall polycythemia prevalence of 2% (95% CI 1-4%); 2% (95% CI 1-3%) in mild-to moderate and 6 % (95% CI 3-12%) in severe OSA. In the pooled analysis of ten single-arm trials including 434 patients, CPAP treatment reduced hemoglobin by 3.76 g/L (95% CI -4.73 to -2.80 g/L). Similarly, pooled analysis of ten single-arm trials including 356 patients without baseline polycythemia showed that CPAP treatment reduced hematocrit by 1.1% (95% CI -1.4 to -0.9%). CONCLUSION Our pooled analysis supports an increased prevalence of secondary polycythemia in OSA. This estimated prevalence is likely underestimated due to the change in the polycythemia diagnostic criteria in 2016. Future randomized controlled trials are needed to evaluate the effect of CPAP in patients with baseline polycythemia. HIGHLIGHTS Pooled analysis shows OSA is associated with an increased prevalence of secondary polycythemiaPrevalence of polycythemia is greater in severe OSACPAP treatment for OSA reduces both the hemoglobin and hematocrit.
Collapse
Affiliation(s)
| | - Eric Carelli
- Department of Medicine, University of Toronto, Toronto, Canada
| | - George A Tomlinson
- Toronto General Hospital Research Institute, Toronto, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, Canada
| | - Kevin H M Kuo
- Department of Medicine, University of Toronto, Toronto, Canada.,Division of Medical Oncology & Hematology, University Health Network, Toronto, Canada
| | - Owen D Lyons
- Department of Medicine, University of Toronto, Toronto, Canada.,Division of Respirology, Women's College Hospital, Toronto, Canada.,Sleep Research Laboratory, Toronto Rehabilitation Institute, Toronto, Canada.,Division of Respirology, University Health Network, Toronto, Canada
| | - Clodagh M Ryan
- Toronto General Hospital Research Institute, Toronto, Canada.,Sleep Research Laboratory, Toronto Rehabilitation Institute, Toronto, Canada.,Division of Respirology, University Health Network, Toronto, Canada
| |
Collapse
|
2
|
Tessema B, Sack U, König B, Serebrovska Z, Egorov E. Effects of Intermittent Hypoxia in Training Regimes and in Obstructive Sleep Apnea on Aging Biomarkers and Age-Related Diseases: A Systematic Review. Front Aging Neurosci 2022; 14:878278. [PMID: 35677200 PMCID: PMC9168371 DOI: 10.3389/fnagi.2022.878278] [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: 02/17/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Several studies have assessed the effects of intermittent hypoxia-normoxia training (IHNT), intermittent hypoxia-hyperoxia training (IHHT), and obstructive sleep apnea (OSA) on aging and age-related diseases in humans; however, the results remain contradictory. Therefore, this review aims to systematically summarize the available studies on the effects of IHNT, IHHT, and OSA on aging and age-related diseases. Relevant studies were searched from PubMed, Google Scholar, Cochrane Library databases, and through manual searching from reference lists of eligible studies. A total of 38 eligible studies were included in this systematic review. IHHT and IHNT provide positive effects on several age-related parameters including quality of life, cognitive and physical functions, plasma level of glucose and cholesterol/LDL, systolic blood pressure, red blood cells, and inflammation. Moreover, moderate intermittent hypoxia induces telomerase reverse transcriptase (TERT) activity and telomere stabilization, delays induction of senescence-associated markers expression and senescence-associated β-galactosidase, upregulates pluripotent marker (Oct4), activates a metabolic shift, and raises resistance to pro-apoptotic stimuli. On the contrary, intermittent hypoxia in OSA causes hypertension, metabolic syndrome, vascular function impairment, quality of life and cognitive scores reduction, advanced brain aging, increase in insulin resistance, plasma hydrogen peroxide, GSH, IL-6, hsCRP, leptin, and leukocyte telomere shortening. Thus, it can be speculated that the main factor that determines the direction of the intermittent hypoxia action is the intensity and duration of exposure. There is no direct study to prove that IHNT/IHHT actually increases life expectancy in humans. Therefore, further study is needed to investigate the actual effect of IHNT/IHHT on aging in humans.Systematic Review Registrationwww.crd.york.ac.uk/prospero, identifier CRD42022298499.
Collapse
Affiliation(s)
- Belay Tessema
- Institute of Clinical Immunology, Faculty of Medicine, Leipzig University, Leipzig, Germany
- Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Faculty of Medicine, Leipzig University, Leipzig, Germany
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Belay Tessema, ,
| | - Ulrich Sack
- Institute of Clinical Immunology, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Brigitte König
- Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Zoya Serebrovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Egor Egorov
- IPAM Institute for Preventive and Anti-Aging Medicine, Berlin, Germany
| |
Collapse
|
3
|
Duan X, Zheng M, Zhao W, Huang J, Lao L, Li H, Lu J, Chen W, Liu X, Deng H. Associations of Depression, Anxiety, and Life Events With the Risk of Obstructive Sleep Apnea Evaluated by Berlin Questionnaire. Front Med (Lausanne) 2022; 9:799792. [PMID: 35463036 PMCID: PMC9021543 DOI: 10.3389/fmed.2022.799792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Psychological problems are prevalent in the general population, and their impacts on sleep health deserve more attention. This study was to examine the associations of OSA risk with depression, anxiety, and life events in a Chinese population. Methods A total of 10,287 subjects were selected from the Guangzhou Heart Study. Berlin Questionnaire (BQ) was used to ascertain the OSA. The Center for Epidemiologic Studies Depression Scale (CES-D) and Zung's self-rating anxiety scale (SAS) were used to define depression and anxiety. A self-designed questionnaire was used to assess life events. Odds ratio (OR) with 95% confidence interval (95% CI) was calculated by using the logistic regression model. Results There were 1,366 subjects (13.28%) classified into the OSA group. After adjusting for potential confounders, subjects with anxiety (OR: 2.60, 95% CI: 1.63-4.04) and depression (OR: 1.91, 95% CI: 1.19-2.97) were more likely to have OSA. Subjects suffering from both anxiety and depression were associated with a 3.52-fold (95% CI: 1.88-6.31) risk of OSA. Every 1-unit increment of CES-D score and SAS index score was associated with 13% (95% CI: 1.11-1.15) and 4% (95% CI: 1.03-1.06) increased risk of OSA. Neither positive life events nor adverse life events were associated with OSA. Conclusions The results indicate that depression and anxiety, especially co-occurrence of both greatly, were associated with an increased risk of OSA. Neither adverse life events nor positive life events were associated with any risk of OSA. Screening for interventions to prevent and manage OSA should pay more attention to depression and anxiety.
Collapse
Affiliation(s)
- Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Jun Huang
- Department of Geriatrics, Institute of Geriatrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Lixian Lao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Haiyi Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiahai Lu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| |
Collapse
|
4
|
Zeng Z, Song Y, He X, Yang H, Yue F, Xiong M, Hu K. Obstructive Sleep Apnea is Associated with an Increased Prevalence of Polycythemia in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2022; 17:195-204. [PMID: 35068930 PMCID: PMC8769057 DOI: 10.2147/copd.s338824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are associated with polycythemia. However, there still remain unanswered questions about the relationship between overlap syndrome (OVS), where OSA and COPD coexist, and polycythemia. Here, we aimed to establish the prevalence of polycythemia in OVS patients and to explore the impact of OSA on polycythemia. Patients and Methods Patients with COPD underwent overnight polysomnography (PSG), pulmonary function tests, echocardiography, and complete blood counts. All patients were ethnic Han Chinese and free of prolonged oral corticosteroid use, hematological system disease, severe systemic disease, and other sleep-disordered breathing. OVS was defined as COPD patients with an apnea–hypopnea index ≥15 events/h, and polycythemia was defined as an Hb >165 g/L in men and >160 g/L in women. Results Eight-hundred and eighty-six patients with COPD were included in the analysis. The prevalence of polycythemia was significantly higher in OVS patients than COPD-alone patients (6.4% vs 2.9%, p < 0.05). The prevalence of polycythemia increased with OSA severity (χ2 = 7.885, p = 0.007), but not in GOLD grade 3–4 COPD patients (χ2 = 0.190, p = 0.663). After adjusting for confounders, percentage of total sleep time with SaO2 <90% (TS90) remained independently associated with an increased odds of polycythemia (OR 1.030, 95% CI 1.015–1.046) and, with an increase in TS90, the hemoglobin increased, especially in GOLD grade 1–2 patients (p < 0.05). Conclusion Patients with OVS have a higher prevalence of polycythemia than those with COPD alone, and TS90 is an independent factor for polycythemia, especially in GOLD1-2 COPD patients.
Collapse
Affiliation(s)
- Zhaofu Zeng
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Yan Song
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Xin He
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Haizhen Yang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Fang Yue
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Mengqing Xiong
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- Correspondence: Ke Hu Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of ChinaTel +86 1897 103 5988 Email
| |
Collapse
|
5
|
Valentim-Coelho C, Vaz F, Antunes M, Neves S, Martins IL, Osório H, Feliciano A, Pinto P, Bárbara C, Penque D. Redox-Oligomeric State of Peroxiredoxin-2 and Glyceraldehyde-3-Phosphate Dehydrogenase in Obstructive Sleep Apnea Red Blood Cells under Positive Airway Pressure Therapy. Antioxidants (Basel) 2020; 9:E1184. [PMID: 33256145 PMCID: PMC7761104 DOI: 10.3390/antiox9121184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022] Open
Abstract
In this study, we examined the effect of six months of positive airway pressure (PAP) therapy on Obstructive Sleep Apnea (OSA) red blood cell (RBC) proteome by two dimensional difference gel electrophoresis (2D-DIGE) - based proteomics followed by Western blotting (WB) validation. The discovered dysregulated proteins/proteoforms are associated with cell death, H2O2 catabolic/metabolic process, stress response, and protein oligomerization. Validation by nonreducing WB was performed for peroxiredoxin-2 (PRDX2) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) by using antibodies against the sulfinylated/sulfonylated cysteine of these proteins to better evaluate their redox-oligomeric states under OSA and/or in response to PAP therapy. The results indicated that the redox-oligomeric state of GAPDH and PRDX2 involving overoxidation by sulfinic/sulfonic acids were differentially modulated in OSA RBC, which might be compromising RBC homeostasis. PAP therapy by restoring this modulation induced a higher oligomerization of overoxidized GAPDH and PRDX2 in some patients that could be associated with eryptosis and the chaperone "gain" of function, respectively. This varied response following PAP may result from the complex interplay between OSA and OSA metabolic comorbidity. Hence, information on the redox status of PRDX2 and GAPDH in RBC will help to better recognize OSA subtypes and predict the therapeutic response in these patients. GAPDH monomer combined with body mass index (BMI) and PRDX2 S-S dimer combined with homeostatic model assessment for insulin resistance (HOMA-IR) showed to be very promising biomarkers to predict OSA and OSA severity, respectively.
Collapse
Affiliation(s)
- Cristina Valentim-Coelho
- Laboratório de Proteómica, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (C.V.-C.); (F.V.); (S.N.); (I.L.M.)
- ToxOmics—Centre of Toxicogenomics and Human Health, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| | - Fátima Vaz
- Laboratório de Proteómica, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (C.V.-C.); (F.V.); (S.N.); (I.L.M.)
- ToxOmics—Centre of Toxicogenomics and Human Health, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| | - Marília Antunes
- Centro de Estatística e Aplicações da Universidade de Lisboa e Departamento de Estatística e Investigação Operacional, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal;
| | - Sofia Neves
- Laboratório de Proteómica, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (C.V.-C.); (F.V.); (S.N.); (I.L.M.)
- ToxOmics—Centre of Toxicogenomics and Human Health, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| | - Inês L. Martins
- Laboratório de Proteómica, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (C.V.-C.); (F.V.); (S.N.); (I.L.M.)
- ToxOmics—Centre of Toxicogenomics and Human Health, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| | - Hugo Osório
- i3S–Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Ipatimup–Institute of Molecular Pathology and Immunology of the University of Porto, University of Porto, 4200-135 Porto, Portugal
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Amélia Feliciano
- Serviço de Pneumologia, Centro Hospitalar Lisboa Norte—CHLN, 1649-035 Lisboa, Portugal; (A.F.); (P.P.); (C.B.)
| | - Paula Pinto
- Serviço de Pneumologia, Centro Hospitalar Lisboa Norte—CHLN, 1649-035 Lisboa, Portugal; (A.F.); (P.P.); (C.B.)
- Instituto de Saúde Ambiental—ISAMB, Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisboa, Portugal
| | - Cristina Bárbara
- Serviço de Pneumologia, Centro Hospitalar Lisboa Norte—CHLN, 1649-035 Lisboa, Portugal; (A.F.); (P.P.); (C.B.)
- Instituto de Saúde Ambiental—ISAMB, Faculdade de Medicina, Universidade de Lisboa, 1649-026 Lisboa, Portugal
| | - Deborah Penque
- Laboratório de Proteómica, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, 1649-016 Lisboa, Portugal; (C.V.-C.); (F.V.); (S.N.); (I.L.M.)
- ToxOmics—Centre of Toxicogenomics and Human Health, Universidade Nova de Lisboa, 1150-082 Lisboa, Portugal
| |
Collapse
|
6
|
CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities. ACTA ACUST UNITED AC 2020; 56:medicina56020080. [PMID: 32075328 PMCID: PMC7074283 DOI: 10.3390/medicina56020080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 02/06/2023]
Abstract
Background and Objectives: Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic dysfunctions negatively influence exercise tolerance in moderate-severe OSA patients. The cardiopulmonary exercise testing (CPET) offers an integrated assessment of the individual's aerobic capacity and helps distinguish the main causes of exercise limitation. The purpose of this study is to evaluate the aerobic capacity of OSA patients, before and after short-term continuous positive airway pressure (CPAP). Materials and Methods: Our prospective study included 64 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) 39.96 ± 19.04 events/h) who underwent CPET before and after CPAP. Thirteen patients were unable to tolerate CPAP or were lost during follow-up. Results: 49.29% of our patients exhibited a moderate or severe decrease in functional capacity (Weber C or D). CPET performance was influenced by gender but not by apnea severity. Eight weeks of CPAP induced significant improvements in maximal exercise load (Δ = 14.23 W, p = 0.0004), maximum oxygen uptake (Δ = 203.87 mL/min, p = 0.004), anaerobic threshold (Δ = 316.4 mL/min, p = 0.001), minute ventilation (Δ = 5.1 L/min, p = 0.01) and peak oxygen pulse (Δ = 2.46, p = 0.007) as well as a decrease in basal metabolic rate (BMR) (Δ = -8.3 kCal/24 h, p = 0.04) and average Epworth score (Δ = -4.58 points, p < 0.000001). Conclusions: Patients with moderate-severe OSA have mediocre functional capacity. Apnea severity (AHI) was correlated with basal metabolic rate, resting heart rate and percent predicted maximum effort but not with anaerobic threshold or maximum oxygen uptake. Although CPET performance was similar in the two apnea severity subgroups, short-term CPAP therapy significantly improved most CPET parameters, suggesting that OSA per se has a negative influence on effort capacity.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Liu X, Song Q, Hu W, Han X, Gan J, Zheng X, Wang X, Wu S. Night Sleep Duration and Risk of Incident Anemia in a Chinese Population: A Prospective Cohort Study. Sci Rep 2018; 8:3975. [PMID: 29507334 PMCID: PMC5838258 DOI: 10.1038/s41598-018-22407-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/22/2018] [Indexed: 12/13/2022] Open
Abstract
The purpose was to study the association between sleep duration and the prevalence of anemia in Chinese people. There were 84,791 participants (men: 79.1%; women: 20.9%) aged 18–98 years in the prospective study. We divided the participants into five categories based on the individual sleep duration: ≤5 h, 6 h, 7 h(reference), 8 h, and ≥9 h. Anemia was defined based on hemoglobin <12 g/dL for men and <11 g/dL for women. The Cox proportional hazards model was used to assess the association between sleep duration and anemia. During median follow-up of 7.9 years, 2698 cases of anemia had occurred. The HRand (95% CI) of anemia (7 h as the reference group) for individuals reporting ≤5 h, 6 h, 8 h, and ≥9 h were 1.23(1.04–1.45), 1.26(1.11–1.44), 1.04(0.92–1.16) and 1.42(1.08–1.86), respectively. It showed that there was a significant interaction on the risk of anemia between sleep duration and sex in the secondary analysis (p < 0.001).The significant association between long sleepduration and anemia was found in women (HR, 2.29; 95% CI, 1.56–3.37), not in men(HR, 0.90; 95% CI, 0.60–1.34). Both short and long night sleep duration were associated with increased risk of anemia.
Collapse
Affiliation(s)
- Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital, North China University of science and technology, Tangshan, China
| | - Qiaofeng Song
- Department of Cardiology, Tangshan People's Hospital, North China University of science and technology, Tangshan, China
| | - Wanning Hu
- The Cancer Institute, Tangshan People's Hospital, Tangshan, China.,Department of Head and Neck Surgery, Tangshan People's Hospital, Tangshan, China
| | - Xiaochen Han
- Department of Head and Neck Surgery, Tangshan People's Hospital, Tangshan, China
| | - Jianhui Gan
- Department of Anesthesia, Tangshan People's Hospital, Tangshan, China
| | - Xiang Zheng
- Department of Nuclear magnetic resonance, Tangshan People's Hospital, Tangshan, China
| | - Xizhu Wang
- Department of Cardiology, Tangshan People's Hospital, North China University of science and technology, Tangshan, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of science and technology, Tangshan, China.
| |
Collapse
|
9
|
Magnitude of Anemia in Geriatric Population Visiting Outpatient Department at the University of Gondar Referral Hospital, Northwest Ethiopia: Implication for Community-Based Screening. Curr Gerontol Geriatr Res 2018. [PMID: 29535765 PMCID: PMC5817376 DOI: 10.1155/2018/9869343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective This study is aimed at assessing the magnitude and its associated factors of anemia in geriatric population visiting outpatient department at the University of Gondar referral hospital, northwest Ethiopia. Method A cross-sectional study was conducted among elder patients in Gondar town, North Gondar District, in May 2013. A total of 200 randomly selected geriatric population participated in the study. Summary statistics were computed and presented in tables and figure. Both bivariate and multivariable binary logistic regression were fitted to identify associated factors. A P value < 0.05 was considered as statistically significant. Result The median age of the study participants was 65 years (Interquartile range (IQR): 8 years). The prevalence of anemia in the geriatric patients was 54.5% (n = 109), of which 61.5% (n = 67) were males. Mild type anemia was predominant, 55.96% (n = 61). Geriatric patients with an elevated erythrocyte sedimentation rate (AOR = 9.04, 95% CI: 4.2–19.7) and who are vegetarians (AOR = 2.2, 95% CI: 1.03–4.71) were at high risk of developing anemia. Conclusion The magnitude of anemia was high in geriatrics. Mild anemia was the predominant type. Vegetarians and geriatrics with elevated erythrocyte sedimentation rate were more likely to develop anemia. Hence, early diagnosis and management of anemia have paramount importance to prevent adverse outcomes in geriatrics.
Collapse
|
10
|
Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure. REVISTA PORTUGUESA DE PNEUMOLOGIA 2017; 23:71-78. [PMID: 28153627 DOI: 10.1016/j.rppnen.2016.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 12/01/2016] [Accepted: 12/27/2016] [Indexed: 01/10/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is a systemic inflammatory disease associated with cardiovascular consequences. Red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) are recognized biomarkers of cardiovascular morbidity/mortality. Limited data is available on the association between these parameters and OSAS severity and the relationship with positive airway pressure therapy (PAP). In this prospective study of male OSAS patients we analyzed hematological data in order to evaluate their value in predicting OSAS severity, the relationship with sleep parameters, and their behavior under PAP. Seventy-three patients were included (mean age 46.5 years), of which 36 were mild (49.3%), 10 moderate (13.7%), and 27 severe (37%). The mean RDW increased significantly with OSAS severity and showed a positive correlation with respiratory disturbance index and hypoxemic burdens. Additionally, a group of 48 patients (mean age 47.2 years) were submitted to PAP. After six months, red blood cell count, hemoglobin, hematocrit, and platelet count showed a significant decrease (p<0.0001; p<0.0001; p=0.001; p<0.0001; respectively). Concerning OSAS severity, these parameters also significantly decreased in mild patients (p=0.003; p=0.043; p=0.020; p=0.014; respectively) but only hemoglobin, hematocrit, and platelet count decreased in severe cases (p<0.0001; p=0.008; p=0.018; respectively). This study demonstrated an association between RDW values and OSAS severity. Moreover, red cell and platelet parameters changed significantly after PAP, supporting its cardiovascular protective effect. RDW may become a simple/inexpensive blood biomarker, making it useful in prioritizing OSAS patients waiting for polysomnography, and red cell and platelet parameters could be useful in PAP follow up.
Collapse
|
11
|
Colas-Ribas C, Signolet I, Henni S, Feuillloy M, Gagnadoux F, Abraham P. High prevalence of known and unknown pulmonary diseases in patients with claudication during exercise oximetry: A retrospective analysis. Medicine (Baltimore) 2016; 95:e4888. [PMID: 27749546 PMCID: PMC5059048 DOI: 10.1097/md.0000000000004888] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/04/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022] Open
Abstract
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease. The second aim of this study was to evaluate the impact of the therapeutic interventions on the walking capacities, after treatment, of the eventually detected pulmonary disorders.We retrospectively analyzed 1482 exercise TcpO2 test results. Patients that had no history of pulmonary disease, but either reported severe dyspnea or showed atypical profiles on their chest exercise-TcpO2, were advised to refer to the department of pneumology for additional investigations.In addition to the 166 patients with a history of pulmonary disease, 158 patients were suspected of unknown pulmonary disease from the result of their TcpO2 test. Many patients (n = 99/158, 62.7%) did not attend a pulmonologist visit. A pulmonary disease was established in 55 (93.2%) of the other 59 patients. Obstructive sleep apnea syndrome (OSAS) was the one and only diagnosis retained in 42/59 patients (71.2%). Among the 47 patients who had a second evaluation of their walking capacity on treadmill, 38 had treatment of the pulmonary disease found, vascular surgery treatment or a severe restricted diet, 9 had no treatment. Only the "treated" group showed a significant improvement in the maximal walking distance on treadmill between the 2 evaluations, 313 ± 251 m to 433 ± 317 m (P = 0.03).This retrospective pilot study underlines the high prevalence of both known and unknown pulmonary disease in patients whose primary complaint was lower limb claudication. Systematic screening and treatment of pulmonary disease in patients with claudication might be justified, to improve walking ability of such patients and possibly reduce or delay the requirement for revascularization. Prospective studies are required to confirm these preliminary results.
Collapse
Affiliation(s)
- Christophe Colas-Ribas
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
| | - Isabelle Signolet
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
| | - Samir Henni
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
| | - Mathieu Feuillloy
- Ecole supérieure d’électronique de l’Ouest, Institute of Science & Technology, France
- LAUM–UMR CNR6613, France
| | - Frédéric Gagnadoux
- Department of Pneumology, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, INSERM 1063, France
| | - Pierre Abraham
- Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France
- Mitovasc, UMR INSERM 1083/CNRS 6214, Univ. Angers, Université Bretagne Loire, Angers, France
| |
Collapse
|
12
|
Connes P. Obstructive sleep apnea and sickle cell disease: Towards hemorheological abnormalities and vascular dysfunction worsening. Sleep Med Rev 2015; 24:101-2. [PMID: 25743618 DOI: 10.1016/j.smrv.2015.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 01/23/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Philippe Connes
- Laboratoire CRIS EA647 - Section "Vascular Biology and Red Blood Cell", Université Lyon 1, COMUE Lyon, Lyon, France; Institut Universitaire de France, Paris, France.
| |
Collapse
|
13
|
Sökücü SN, Ozdemir C, Dalar L, Karasulu L, Aydın S, Altın S. Complete blood count alterations after six months of continuous positive airway pressure treatment in patients with severe obstructive sleep apnea. J Clin Sleep Med 2014; 10:873-8. [PMID: 25126033 DOI: 10.5664/jcsm.3958] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
STUDY OBJECTIVES The cardiovascular complications caused by obstructive sleep apnea (OSA) decrease after continuous positive airway pressure treatment (CPAP). Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. METHODS From a selection of patients with symptoms of nocturnal snoring and/or excessive daytime sleepiness, 36 males with an apnea-hypopnea index (AHI) > 30/h and 22 age-matched normal male controls with AHI < 5/h were included. Patients with OSA underwent another night of CPAP titration, and 11 patients were excluded at the 6-month evaluation due to poor compliance with the home CPAP therapy. Complete blood count parameters of compliant patients and the control group were evaluated. RESULTS Compared to controls, MPV values were significantly higher (p = 0.025) in OSA patients, but no significant differences in PDW or RDW were found (p > 0.05). Six months of CPAP therapy resulted in significantly lower MPV values but increased values of PDW and RDW in patients with severe OSA (p = 0.001, p = 0.007, p = 0.001, respectively). CONCLUSION Our data suggest that complete blood count parameters in OSA patients such as MPV, PDW and RDW change significantly after CPAP therapy.
Collapse
Affiliation(s)
- Sinem Nedime Sökücü
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey
| | - Cengiz Ozdemir
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey
| | - Levent Dalar
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey
| | - Levent Karasulu
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey
| | - Senay Aydın
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey
| | - Sedat Altın
- Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Department of Chest Disease, Istanbul, Turkey
| |
Collapse
|
14
|
Obstructive sleep apnea and incidence of postoperative delirium after elective knee replacement in the nondemented elderly. Anesthesiology 2012; 116:788-96. [PMID: 22337162 DOI: 10.1097/aln.0b013e31824b94fc] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Postoperative delirium, a common complication in the elderly, can occur following any type of surgery and is associated with increased morbidity and mortality; it may also be associated with subsequent cognitive problems. Effective therapy for postoperative delirium remains elusive because the causative factors of delirium are likely multiple and varied. METHODS Patients 65 yr or older undergoing elective knee arthroplasty were prospectively evaluated for postoperative Diagnostic and Statistical Manual of Mental Disorders-IV delirium. Exclusion criteria included dementia, mini-mental state exam score less than 24, delirium, clinically significant central nervous system/neurologic disorder, current alcoholism, or any serious psychiatric disorder. Delirium was assessed on postoperative days 2 and 3 using standardized scales. Patients' preexisting medical conditions were obtained from medical charts. The occurrence of obstructive sleep apnea was confirmed by contacting patients to check their polysomnography records. Data were analyzed using Pearson chi-square or Wilcoxon rank sum tests and multiple logistic regressions adjusted for effects of covariates. RESULTS Of 106 enrolled patients, 27 (25%) developed postoperative delirium. Of the 15 patients with obstructive sleep apnea, eight (53%) experienced postoperative delirium, compared with 19 (20%) of the patients without obstructive sleep apnea (P = 0.0123, odds ratio: 4.3). Obstructive sleep apnea was the only statistically significant predictor of postoperative delirium in multivariate analyses. CONCLUSIONS This is the first prospective study employing validated measures of delirium to identify an association between preexisting obstructive sleep apnea and postoperative delirium.
Collapse
|