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Kovbasyuk Z, Ramos-Cejudo J, Parekh A, Bubu OM, Ayappa IA, Varga AW, Chen MH, Johnson AD, Gutierrez-Jimenez E, Rapoport DM, Osorio RS. Obstructive Sleep Apnea, Platelet Aggregation, and Cardiovascular Risk. J Am Heart Assoc 2024; 13:e034079. [PMID: 39056328 DOI: 10.1161/jaha.123.034079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/31/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Although related, the precise mechanisms linking obstructive sleep apnea (OSA) and cardiovascular disease (CVD) are unclear. Platelets are mediators of CVD risk and thrombosis and prior studies suggested associations of OSA and platelet activity. The aim of this study is to assess the link between OSA, platelet activity, and CVD-related risk factors. METHODS AND RESULTS We studied the association of OSA-measures and platelet aggregation in participants dually enrolled in the SHHS (Sleep Heart and Health Study) and FHS (Framingham Heart Study). We applied linear regression models with adjustment for demographic and clinical covariates and explored interactions with OSA and CVD-related factors, including age, sex, body mass index, hypertension, OSA diagnosis (apnea-hypopnea index 4%≥5), and aspirin use. Our final sample was of 482 participants (60 years [14.00], 50.4% female). No associations were observed between apnea-hypopnea index 4% and platelet aggregation in the main sample. Stratified analysis revealed an association in aspirin users (n=65) for our primary exposure (apnea-hypopnea index 4%, β=0.523; P<0.001; n=65), and secondary exposures: hypoxic burden (β=0.358; P<0.001), minimum saturation (β=-0.519; P=0.026), and oxygen desaturation index 3% (β=74.672; P=0.002). No associations were detected in nonaspirin users (n=417). CONCLUSIONS No associations were detected between OSA and platelet aggregation in a community sample. Our finding that OSA associates with increased platelet aggregation in the aspirin group, most of whom use it for primary prevention of CVD, suggests that platelet aggregation may mediate the adverse impact of OSA on vascular health in individuals with existing CVD risk, supporting further investigation.
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Affiliation(s)
- Zanetta Kovbasyuk
- Healthy Brain Aging and Sleep Center Department of Psychiatry New York University Langone Medical Center New York City NY
| | - Jaime Ramos-Cejudo
- Division of Brain Aging Department of Psychiatry New York University Grossman School of Medicine New York City NY
| | - Ankit Parekh
- Division of Pulmonary Critical Care and Sleep Medicine Icahn School of Medicine at Mount Sinai New York City NY
| | - Omonigho M Bubu
- Healthy Brain Aging and Sleep Center Department of Psychiatry New York University Langone Medical Center New York City NY
| | - Indu A Ayappa
- Division of Pulmonary Critical Care and Sleep Medicine Icahn School of Medicine at Mount Sinai New York City NY
| | - Andrew W Varga
- Division of Pulmonary Critical Care and Sleep Medicine Icahn School of Medicine at Mount Sinai New York City NY
| | - Ming-Huei Chen
- Population Sciences Branch National Heart, Lung, and Blood Institute Framingham MA
| | - Andrew D Johnson
- Population Sciences Branch National Heart, Lung, and Blood Institute Framingham MA
| | | | - David M Rapoport
- Division of Brain Aging Department of Psychiatry New York University Grossman School of Medicine New York City NY
| | - Ricardo S Osorio
- Healthy Brain Aging and Sleep Center Department of Psychiatry New York University Langone Medical Center New York City NY
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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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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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Soltani M, Sarvestan A, Hoseinzadeh F, Ahmadizad S, Kingsley JD. The effects of type of recovery in resistance exercise on responses of platelet indices and hemodynamic variables. PLoS One 2023; 18:e0290076. [PMID: 37595001 PMCID: PMC10437857 DOI: 10.1371/journal.pone.0290076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023] Open
Abstract
To examine the effects of two different volume-matched resistance exercise (RE) recovery protocols (passive and active) on platelet indices and hemodynamic variables. Twelve Healthy participants (mean ± SD; 25 ± 3 yrs) completed a traditional resistance exercise (TRE) protocol that included three sets of six repetitions at 80% one repetition maximum (1RM) with two minutes passive recovery between sets, exercises and an interval resistance exercise (IRE) protocol that included three sets of six repetitions at 60%1RM followed by active recovery including six repetitions of the same exercise at 20%1RM. Blood samples for multiple platelet indices were taken before the protocols, immediately-post (IP), and after 1-hour recovery. Hemodynamic variables were measured before, IP, and every five minutes during recovery. Mean platelet volume and platelet large cell ratio P_LCR decreased from baseline to recovery. Heart rate (HR) and rate pressure product (RPP) were augmented at IP following IRE compared to TRE. HR was significantly elevated for 20 minutes after both RE protocols, and RPP recovered by five minutes. Systolic blood pressure was increased at IP compared to baseline and all recovery time points for both RE protocols. Our research demonstrated that both RE protocols, produced transient increases in platelet indices (MPV, and P_LCR) and hemodynamic variables (SBP, HR, and RPP), all of which returned to baseline within an hour. Notably, the IRE protocol elicited a greater increase in HR and RPP compared to the TRE protocol.
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Affiliation(s)
- Mohammad Soltani
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Atefe Sarvestan
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - Fatemeh Hoseinzadeh
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - Sajad Ahmadizad
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - J. Derek Kingsley
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH, United States of America
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Kallel S, Kchaou K, Kharrat I, Chaabouni MA, Ayedi S, Charfeddine I. Association between mean platelet volume and cardiovascular disease in obstructive sleep apnea syndrome. SAGE Open Med 2023; 11:20503121231181634. [PMID: 37388904 PMCID: PMC10302667 DOI: 10.1177/20503121231181634] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/26/2023] [Indexed: 07/01/2023] Open
Abstract
Objectives Obstructive sleep apnea syndrome is associated with cardiovascular diseases. Mean platelet volume has emerged as a marker of prothrombotic conditions and cardiovascular risk. The aim of this study was to investigate the association between the mean platelet volume and cardiovascular diseases in patients with obstructive sleep apnea syndrome. Methods The medical records of 207 patients were analyzed. Obstructive sleep apnea syndrome was diagnosed by polygraphy, and patients were classified according to apnea-hypopnea index: control group: individuals with simple snoring (apnea-hypopnea index < 5), mild obstructive sleep apnea syndrome group (5 ⩽ apnea-hypopnea index < 15), moderate obstructive sleep apnea syndrome group (15 ⩽ apnea-hypopnea index < 30), and severe obstructive sleep apnea syndrome group (apnea-hypopnea index ⩾ 30). Mean platelet volume was obtained from medical records. Cardiovascular diseases were defined if patients had hypertension, heart failure, coronary artery disease, or arrythmia. The independent predictors related to cardiovascular diseases in obstructive sleep apnea syndrome were determined by using multiple logistic regression analysis. Results Of the patients, 175 were included in the analysis. Sixty-three (36%) were males and 112 (64%) were females. The mean age was 51.85 ± 11 years. There were, 26 (14.9%), 53 (30.3%), 38 (21.7%), and 58 (33.1%) participants in the simple snoring, mild, moderate, and severe obstructive sleep apnea syndrome groups, respectively. Cardiovascular diseases were significantly different between the four groups (p = 0.014). Mean platelet volume in severe obstructive sleep apnea syndrome group was significantly higher than in mild or moderate obstructive sleep apnea syndrome group and simple snoring group (p < 0.05). Moreover, there was a positive correlation between mean platelet volume levels and apnea-hypopnea index (r = 0.424; p < 0.001). The independent predictors of cardiovascular diseases in obstructive sleep apnea syndrome were age (p < 0.001; odds ratio = 1.134; confidence interval: 1.072-1.2), body mass index (p = 0.012; odds ratio: 1.105; confidence interval: 1.022-1.194), and mean platelet volume (p < 0.001; odds ratio: 2.092; confidence interval: 1.386-3.158). Conclusion The present study demonstrated that there is an association between mean platelet volume levels and cardiovascular diseases in patients with obstructive sleep apnea syndrome.
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Affiliation(s)
- Souha Kallel
- Souha Kallel, Department of ENT and Cervicofacial Surgery. Habib Bourguiba’s Teaching Hospital, University of Sfax, El Ferdaous Avenue, Sfax 3029, Tunisia.
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KILIÇ T, SENGOR M, ÜSTÜNOVA S, KILIC A, DAŞKAYA H, ÖZER AY. The Effects of Therapeutic Intermittent Hypoxia Implementation on Complete Blood Count Parameters: An Experimental Animal Model. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022; 12:746-752. [DOI: 10.33808/clinexphealthsci.1018541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Objective: Intermittent hypoxia (IH) implementation is a method performed by intermittently decreasing oxygen concentration in inhaled air at specific rate. This method varies between studies in terms of its application. This study aims to examine the changes in Complete Blood Count (CBC) parameters caused by IH implementation at therapeutic dose ranges with a single model.
Methods: Ten Sprague Dawley type adult male rats were divided into two groups. In the study group, FiO2 level of inhaled air, was reduced to 10% in hypoxic cycle. 5 minutes normoxia-hypoxia cycle was used in each 30 minutes experiment period for study group. Control group remained in normoxic air for 30 minutes. 1 cc of blood was taken from mandibular vein from all rats at the end of 6th day. CBC analyzes were performed and differences between two groups were investigated.
Results: Significant differences were detected in some CBC parameters between the two groups. It was determined that significant increase in MONO (p
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Affiliation(s)
- Talha KILIÇ
- MARMARA UNIVERSITY, FACULTY OF HEALTH SCIENCES
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7
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Luo B, Li Y, Zhu M, Cui J, Liu Y, Liu Y. Intermittent Hypoxia and Atherosclerosis: From Molecular Mechanisms to the Therapeutic Treatment. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1438470. [PMID: 35965683 PMCID: PMC9365608 DOI: 10.1155/2022/1438470] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 12/24/2022]
Abstract
Intermittent hypoxia (IH) has a dual nature. On the one hand, chronic IH (CIH) is an important pathologic feature of obstructive sleep apnea (OSA) syndrome (OSAS), and many studies have confirmed that OSA-related CIH (OSA-CIH) has atherogenic effects involving complex and interacting mechanisms. Limited preventive and treatment methods are currently available for this condition. On the other hand, non-OSA-related IH has beneficial or detrimental effects on the body, depending on the degree, duration, and cyclic cycle of hypoxia. It includes two main states: intermittent hypoxia in a simulated plateau environment and intermittent hypoxia in a normobaric environment. In this paper, we compare the two types of IH and summarizes the pathologic mechanisms and research advances in the treatment of OSA-CIH-induced atherosclerosis (AS), to provide evidence for the systematic prevention and treatment of OSAS-related AS.
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Affiliation(s)
- Binyu Luo
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yiwen Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Mengmeng Zhu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Jing Cui
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yanfei Liu
- The Second Department of Gerontology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yue Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China
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Vitamin D Level in Patients with Consecutive Acute Coronary Syndrome Is Not Correlated with the Parameters of Platelet Activity. J Clin Med 2022; 11:jcm11030707. [PMID: 35160157 PMCID: PMC8836793 DOI: 10.3390/jcm11030707] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/05/2023] Open
Abstract
Coronary artery disease continues to be the leading cause of death in developed countries. Elevated mean platelet volume (MPV) is associated with an increased incidence of myocardial infarction (MI) and MI-related mortality. Vitamin D concentrations affect the level and function of platelets, which are the crucial mediator of atherothrombosis and plaque rupture. The main aim of this study was to examine the relationship of serum 25-hydroxyvitamin D (25(OH)D) levels with the platelet activity in patients with a history of an acute coronary syndrome (ACS). This prospective study recruited 268 patients with a history of MI who underwent coronary angiography due to the suspicion of another ACS. Serum 25(OH)D concentration was determined by electrochemiluminescence. Platelet activity was assessed using the MPV and platelet-large cell ratio (P-LCR) parameters. There was no significant difference in MPV and P-LCR values between patients diagnosed with subsequent MI and patients with chronic coronary syndrome (CCS). A significantly lower level of 25(OH)D was demonstrated in patients who had another MI compared to those with CCS (p < 0.05). No significant correlation of 25(OH)D concentrations with platelet activity parameters values was found. The subgroup of patients with consecutive MI was characterized by significantly lower serum vitamin D levels, but this was not related to the analyzed parameters of platelet activity.
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9
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He L, Lin Z. An Exploratory Study on the Treatment of Obstructive Apnea-Hypopnea Syndrome by Nasal Cavity Expansion. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6926509. [PMID: 34804458 PMCID: PMC8601791 DOI: 10.1155/2021/6926509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/13/2021] [Accepted: 10/16/2021] [Indexed: 11/18/2022]
Abstract
Background Respiratory disorder is a disease with a very high incidence, in which obstructive apnea-hypopnea syndrome is the most harmful. It has become a common and frequently occurring disease, which seriously influences the health of the affected population. The pathogenesis of obstructive sleep apnea/hypopnea syndrome (OSAHS) is numerous. With the continuous research on OSAHS disease, it has been found that one of its main pathogeneses is caused by the anatomical characteristics of upper airway obstruction induced during sleep. The narrowing and collapse of any plane can affect the ventilation of the upper respiratory tract. In recent years, with the deepening of research, the importance of the upper respiratory tract obstruction as a source of the disease has attracted increasing attention. Nasal stenosis can cause increased nasal resistance, increased pharyngeal inhalation negative pressure, soft palate collapse, and narrow pharyngeal cavity, resulting in open mouth breathing, which can be the initiating factor of the upper airway obstruction. With the development and popularization of nasal endoscopy technology, domestic and foreign scholars have reported more on the treatment of rhinogenic OSAHS with nasal cavity expansion, but they are different. There is still more controversy; the main controversy centered on the effective rate of surgical treatment and the improvement of objective indicators. Therefore, this study performed individualized nasal cavity expansion for patients with OSAHS who are mainly rhinogenic, from subjective symptoms, objective indicators, and effective rate of surgery. Methods and Patients. Conduct research and analysis to provide references for the clinical treatment of such patients. For patients with the obstructive apnea-hypopnea syndrome with nasal congestion, individualized nasal cavity expansion was performed to study the clinical effect of nasal cavity expansion in the treatment of OSAHS. This article mainly screens cases through big data and selects a large hospital in China to perform individualized nasal cavity expansion surgery to treat 43 adult OSAHS patients with nasal congestion. Results There are uploaded sleep monitoring, nasal reflex, nasal resistance, and nasal symptoms before and after surgery. Conclusion Spirometer examination records, along with apnea-hypopnea index and minimum arterial blood oxygen saturation, the minimum cross-sectional area of the nasal cavity, nasal cavity volume, nasal airway resistance, total nasal respiratory volume, and other information. Also we fill in the nasal obstruction symptom assessment scale, sleepiness scale, and study and analyze the surgical effect of nasal cavity expansion.
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Affiliation(s)
- Ling He
- Hebei Eye Hospital, Otolaryngology-Head and Neck Surgery, Xingtai 054001, China
| | - Zhijin Lin
- Xingtai People's Hospital, Doctor-Patient Communication Office, Xingtai 054001, China
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10
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Kontos A, Willoughby S, Lushington K, Martin J, Wabnitz D, Dorrian J, Kennedy D. Increased Platelet Aggregation in Children and Adolescents with Sleep-disordered Breathing. Am J Respir Crit Care Med 2020; 202:1560-1566. [PMID: 32628860 DOI: 10.1164/rccm.201911-2229oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Rationale: Sleep-disordered breathing (SDB) is associated with increased vascular resistance in children and adults. Persistent increased vascular resistance damages vascular endothelial cells-a marker of which is increased platelet activation.Objectives: This study compared whole-blood impedance platelet aggregation in children with clinically diagnosed SDB warranting adenotonsillectomy and healthy control subjects.Methods: Thirty children who had SDB warranting intervention clinically diagnosed by experienced pediatric otolaryngologists were recruited from adenotonsillectomy waitlists, and 20 healthy children from the community underwent overnight polysomnography to determine SDB severity (obstructive apnea-hypopnea index). Snoring frequency was collected from parents. In the morning, a fasting blood sample was taken, and whole-blood platelet aggregation was measured.Measurements and Main Results: Children with SDB exhibited increased platelet aggregation to TRAP (thrombin receptor-activating peptide) (children with SDB = 114.8 aggregation units [AU] vs. control subjects = 98.0 AU; P < 0.05) and COL antibody (96.7 vs. 82.2 AU; P < 0.05) and an increased trend in ADP antibody (82.3 vs. 69.2 AU; P < 0.07) but not aspirin dialuminate (82.1 vs. 79.5 AU; P > 0.05). No significant association was observed between either the obstructive apnea-hypopnea index and any aggregation parameter, but parental report of snoring was positively associated with TRAP aggregation (Kendall's τ-c = 0.23; P < 0.05).Conclusions: The finding of increased platelet aggregation is consistent with endothelial damage. This suggests that the profile of cardiovascular changes noted in adults with SDB may also occur in children with SDB.
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Affiliation(s)
- Anna Kontos
- Department of Respiratory and Sleep Medicine and.,Robinson Research Institute.,Discipline of Paediatrics, School of Medicine, and
| | - Scott Willoughby
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia; and
| | - Kurt Lushington
- Robinson Research Institute.,Centre for Behaviour, Brain and Body, Justice and Society Unit, University of South Australia, Adelaide, South Australia, Australia
| | - James Martin
- Department of Respiratory and Sleep Medicine and.,Robinson Research Institute.,Discipline of Paediatrics, School of Medicine, and
| | - David Wabnitz
- Department of Otolaryngology, Head and Neck Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Jill Dorrian
- Centre for Behaviour, Brain and Body, Justice and Society Unit, University of South Australia, Adelaide, South Australia, Australia
| | - Declan Kennedy
- Department of Respiratory and Sleep Medicine and.,Robinson Research Institute.,Discipline of Paediatrics, School of Medicine, and
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Ulusoy B, Oğuzhan T, Akyol M, Bozdemir K, Çiftçi B, Korkmaz MH. Insufficiency of positive airway pressure treatment on increased mean platelet volume: a prospective controlled study in patients with obstructive sleep apnea syndrome. Sleep Breath 2019; 24:885-891. [PMID: 31392572 DOI: 10.1007/s11325-019-01918-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/21/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND To analyze the association between obstructive sleep apnea syndrome (OSAS) and some hematological variables such as mean platelet volume (MPV), platelet distribution width (PDW), and the impact of positive airway pressure (PAP) treatment on these parameters. METHODS The participants of the present prospective study consist of 36 OSAS patients diagnosed with polysomnography and recommended PAP treatment and 30 healthy members as the control group. Complete blood analyses were conducted to the patient group twice; before the initiation of the PAP treatment and 1 month after regular PAP use. The control group was administered a complete blood analyses only once. Patient and control group were compared in terms of various parameters such as MPV, PDW, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) values, and platelet counts. RESULTS MPV value of the patient group was before and after PAP treatment significantly higher than the control group (respectively; Z = 2.246; p = 0.025, and Z = 2.033; p = 0.042). However, there were no statistically significant differences in the values before and after PAP treatment in the patient group (Z = 0.727; p = 0.467). In terms of platelet numbers and PDW values, no significant differences were determined (p > 0.05). CONCLUSION MPV value was significantly elevated in OSAS patients. However, the 1 month of PAP treatment was insufficient in decreasing elevated MPV values.
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Affiliation(s)
- Bülent Ulusoy
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Selçuk University, 42075, Konya, Turkey.
| | - Tolga Oğuzhan
- Department of Otorhinolaryngology-Head and Neck Surgery, Fatih Medical Park Hospital, Istanbul, Turkey
| | - Mesut Akyol
- Department of Biostatistics, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Kazım Bozdemir
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Bülent Çiftçi
- Department of Pulmonary Disease, Bozok University, Yozgat, Turkey
| | - Mehmet Hakan Korkmaz
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
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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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13
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Wu M, Zhou L, Zhu D, Lai T, Chen Z, Shen H. Hematological indices as simple, inexpensive and practical severity markers of obstructive sleep apnea syndrome: a meta-analysis. J Thorac Dis 2018; 10:6509-6521. [PMID: 30746195 DOI: 10.21037/jtd.2018.10.105] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Clinical detection of inflammatory markers is useful to assess the degree of nocturnal hypoxia and predict the presence of complications in obstructive sleep apnea syndrome (OSAS) patients. Nowadays, some researchers proposed that hematological parameters could be substituted for novel disease-specific biochemical markers (such as C-reactive protein) because they were comparatively cheap, simple and practical. But there was a contradiction whether the hematological parameters were positively correlated with the OSAS severity. Methods Medical databases were searched included PubMed, Web of Science, Scopus, Cochrane Library, Clinical Trial, Embase and Google Scholar (up to March 29, 2018). We used weighted mean differences (WMDs) with 95% confidence intervals (CIs) from random-effects model. Results Seventeen studies were included in this meta-analysis and results were presented by different hematological parameters. Pooled analysis showed that OSAS was associated with a high level of WBC (white blood cell, 11 studies, 2,206 subjects, WMD: 0.58; 95% CI: 0.31 to 0.85; P<0.0001), NLR (neutrophil-to-lymphocyte ratio, 5 studies, 1416 subjects, WMD: 0.46; 95% CI: 0.13 to 0.80; P=0.007), MPV (mean platelet volume, 8 studies, 1,854 subjects, WMD: 0.63; 95% CI: 0.29 to 0.98; P=0.0004), PDW (platelet distribution width, 6 studies, 1,911 subjects, WMD: 0.76; 95% CI: 0.47 to 1.06; P<0.00001), PLR (platelet-to-lymphocyte ratio, 3 studies, 998 subjects, WMD: 21.76; 95% CI: 8.54 to 34.99; P=0.001), RDW (red cell distribution width, 5 studies, 1,701 subjects, WMD: 0.31; 95% CI: 0.11 to 0.51; P=0.002) and HCT (hematocrit, 3 studies, 662 subjects, WMD: 1.58; 95% CI: 0.52 to 2.64; P=0.003). But OSAS was associated with a low level of LYM (lymphocyte, 5 studies, 1,285 subjects, WMD: -0.27; 95% CI: -0.49 to -0.06; P=0.01). There was a gradual rising trend from mild OSAS to severe OSAS existed in all subgroups. Conclusions Hematological indices are comparatively Simple, Inexpensive and Practical Severity Markers of OSAS including WBC, LYM, NLR, MPV, PDW, PLR, RDW and HCT.
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Affiliation(s)
- Mindan Wu
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lingren Zhou
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ding Zhu
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Tianwen Lai
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.,Department of Respiratory and Critical Care Medicine, Affiliated Hospital, Institute of Respiratory Diseases, Guangdong Medical University, Zhanjiang 524000, China
| | - Zhihua Chen
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Huahao Shen
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.,State Key Lab. for Respiratory Diseases, Guangzhou 510120, China
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14
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Gabryelska A, Łukasik ZM, Makowska JS, Białasiewicz P. Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood Platelets. Front Neurol 2018; 9:635. [PMID: 30123179 PMCID: PMC6085466 DOI: 10.3389/fneur.2018.00635] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022] Open
Abstract
Obstructive sleep apnea is a chronic condition characterized by recurrent episodes of apneas or hypopneas during sleep leading to intermittent hypoxemia and arousals. The prevalence of the sleep disordered breathing is estimated that almost 50% of men and 24% of women suffer from moderate to severe form of the disorder. Snoring, collapse of upper airways and intermittent hypoxia are main causes of smoldering systemic inflammation in patients suffering from obstructive sleep apnea. The systematic inflammation is considered one of the key mechanisms leading to significant cardiovascular complications. Blood platelets, formerly not even recognized as cells, are currently gaining attention as crucial players in the immune continuum. Platelet surface is endowed with receptors characteristic for cells classically belonging to the immune system, which enables them to recognize pathogens, immune complexes, and interact in a homo- and heterotypic aggregates. Platelets participate in the process of transcellular production of bioactive lipids by delivering both specific enzymes and substrate molecules. Despite their lack of nucleus, platelets synthetize proteins in a stimuli-dependent manner. Atherosclerosis and consequent cardiovascular complications result from disruption in homeostasis of both of the platelet roles: blood coagulation and inflammatory processes modulation. Platelet parameters, routinely evaluated as a part of complete blood count test, were proposed as markers of cardiovascular comorbidity in patients with obstructive sleep apnea. Platelets were found to be excessively activated in this group of patients, especially in obese subjects. Persistent activation results in enhanced spontaneous aggregability and change in cytokine production. Platelet-lymphocyte ratio was suggested as an independent marker for cardiovascular disease in obstructive sleep apnea syndrome and continuous positive air pressure therapy was found to have an impact on platelet parameters and phenotype. In this literature review we summarize the current knowledge on the subject of platelets involvement in obstructive sleep apnea syndrome and consider the possible pathways in which they contribute to cardiovascular comorbidity.
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Affiliation(s)
- Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Zuzanna M Łukasik
- Department of Rheumatology, Medical University of Lodz, Lodz, Poland
| | - Joanna S Makowska
- Department of Rheumatology, Medical University of Lodz, Lodz, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
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15
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Archontogeorgis K, Voulgaris A, Papanas N, Nena E, Froudarakis M, Mikhailidis DP, Steiropoulos P. Mean Platelet Volume and Platelet Distribution Width in Patients With Obstructive Sleep Apnea Syndrome and Concurrent Chronic Obstructive Pulmonary Disease. Clin Appl Thromb Hemost 2018; 24:1216-1222. [PMID: 30016881 PMCID: PMC6714785 DOI: 10.1177/1076029618788178] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Evidence suggests that there is platelet activation in obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). Our objective is to evaluate mean platelet volume (MPV) and platelet distribution width (PDW) in patients with overlap syndrome (OS), that is, concurrent COPD with OSAS. Mean platelet volume and PDW were assessed in consecutive patients who had undergone polysomnography and pulmonary function testing. They were divided into the following groups: controls (apnea-hypopnea index [AHI] <5/hour, and forced expiratory volume in 1st second [FEV1]/forced vital capacity [FVC] >70%), OSAS group (AHI ≥5/hour and FEV1/FVC >70%), and OS group (AHI ≥5/hour and FEV1/FVC <70%). A total of 485 patients (360 males and 125 females) were included. Mean platelet volume in controls was lower compared with the other groups: 10 ± 0.9 fL for controls versus 10.3 ± 1.2 fL for OSAS ( P = .006), versus 10.7 ± 1 fL for OS ( P < .001). Additionally, MPV was higher in OS group than OSAS: 10.7 ± 1 fL versus 10.3 ± 1.2 fL, respectively ( P = .002). Platelet distribution width was lower in controls compared with the other groups: 12.9 ± 2 fL for controls versus 13.6 ± 1.9 fL for OSAS ( P = .007), versus 13.8 ± 2.3 fL for OS ( P = .008), while there was no difference between OS and OSAS groups. Mean platelet volume and PDW are increased in patients with OS compared with healthy controls, with respiratory function being the major contributor in platelet activation in this series.
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Affiliation(s)
| | - Athanasios Voulgaris
- 1 Medical School, Democritus University of Thrace, Alexandroupolis, Greece.,2 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Papanas
- 3 Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evangelia Nena
- 4 Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Marios Froudarakis
- 2 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitri P Mikhailidis
- 5 Department of Clinical Biochemistry, Royal Free Hospital, University College London, London, United Kingdom
| | - Paschalis Steiropoulos
- 1 Medical School, Democritus University of Thrace, Alexandroupolis, Greece.,2 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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16
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Li Z, Wang J, Han X, Yuan J, Guo H, Zhang X, Zheng D, Tang Y, Yang H, He M. Association of mean platelet volume with incident type 2 diabetes mellitus risk: the Dongfeng-Tongji cohort study. Diabetol Metab Syndr 2018; 10:29. [PMID: 29651306 PMCID: PMC5894209 DOI: 10.1186/s13098-018-0333-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 04/05/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Most of prior studies to demonstrate the association between mean platelet volume (MPV) and type 2 diabetes mellitus (T2DM) risk were cross-sectional design with inconsistent results. In the present prospective cohort study, we aimed to explore the relationship between MPV and incident T2DM risk among a middle-aged and older Chinese population. METHODS This prospective study included 14,009 individuals derived from the Dongfeng-Tongji cohort which was launched in 2008. A total of 997 incident T2DM patients were diagnosed during the mean 4.51 years of follow-up period. MPV levels were divided into quartiles. The adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) of incident T2DM was estimated by Cox proportional hazard models. RESULTS Compared with study participants with MPV < 7.49 fL, the HRs of T2DM incidence were 1.39 (95% CI 1.11-1.75), 1.14 (0.90-1.44), and 1.39 (95% CI 1.07-1.81) in study participants with 7.49 ≤ MPV < 8.43 fL, 8.43 fL ≤ MPV < 9.69 fL and MPV ≥ 9.69 fL, respectively. This positive association was more pronounced after exclusion of the newly diagnosed incident cases during the first 2 years follow-up. Further adjustment for baseline fasting blood glucose level (FBG) did not materially alter the positive association. The positive association was particularly evident among females, non-current smokers and study participants with FBG level less than 5.6 mmol/L at baseline. CONCLUSION Higher levels of MPV were independently associated with increased incident risk of T2DM in a middle-aged and older Chinese population.
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Affiliation(s)
- Zhaoyang Li
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Jing Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Xu Han
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Jing Yuan
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Huan Guo
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Dan Zheng
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Yuhan Tang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei China
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030 Hubei China
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17
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Nguyen CD, Holty JEC. Does untreated obstructive sleep apnea cause secondary erythrocytosis? Respir Med 2017; 130:27-34. [PMID: 29206630 DOI: 10.1016/j.rmed.2017.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/02/2017] [Accepted: 07/04/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND The current literature suggests a relationship between obstructive sleep apnea (OSA) severity and hematocrit. However, the degree that OSA contributes to clinically significant erythrocytosis is uncertain. The aim of this study is to evaluate this association in a large study sample controlling for multiple confounders. METHODS We evaluated consecutive subjects with suspected untreated OSA using multivariate analysis to test the associations between apnea-hypopnea index (AHI) and hematocrit. Subjects were evaluated with sleep studies, comprehensive sleep questionnaires, and detailed electronic medical record reviews to document their medical comorbidities, and demographic and laboratory information. RESULTS 1604 consecutive veterans (age 57.6 ± 13.4 years, 92% male) were included in the analysis with 77.4% diagnosed with OSA. However, few included subjects (1.6%) had clinical erythrocytosis. OSA severity defined by AHI was not associated with hematocrit or clinically significant erythrocytosis. Rather, awake oxygen saturation (-0.17 points, p < 0.001) and mean nocturnal oxygen saturation (-0.08 points, p = 0.04) were inversely proportional to hematocrit (per standardized Z-score). Other factors including active tobacco, increased alcohol ingestion and exogenous testosterone therapy were associated with higher hematocrit. Although AHI was not predictive of erythrocytosis, having severe OSA was predictive of nocturnal hypoxemia (adjusted OR 7.4, p < 0.001). CONCLUSIONS Hematocrit levels and presence of erythrocytosis appear not associated with OSA severity, but rather with hypoxemia as measured by awake and to a lesser extent mean nocturnal oxygen saturation. Nocturnal oximetry may provide diagnostic utility in the evaluation of unexplained secondary polycythemia and polysomongraphy may be warranted in those with unexplained nocturnal hypoxemia and erythrocytosis.
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Affiliation(s)
- Christopher D Nguyen
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Palo Alto, CA, USA; Stanford Sleep Medicine Center, Department of Psychiatry, Stanford University, Palo Alto, CA, USA
| | - Jon-Erik C Holty
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Palo Alto, CA, USA; Pulmonary, Critical Care and Sleep Medicine Section, VA Palo Alto Health Care System, Palo Alto, CA, USA; Center for Health Policy (CHP/PCOR), Stanford University, Palo Alto, CA, USA.
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18
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Erdim I, Erdur O, Oghan F, Mete F, Celik M. Blood count values and ratios for predicting sleep apnea in obese children. Int J Pediatr Otorhinolaryngol 2017; 98:85-90. [PMID: 28583511 DOI: 10.1016/j.ijporl.2017.04.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To detect whether the mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are contributing factors in the diagnosis and severity of sleep apnea in obese children. INTRODUCTION Obesity is a public health problem, and its prevalence increases daily. Although PSG is the gold standard test in the investigation of sleep apnea, the application of this test requires equipment, personnel, time, and cost. There is no simple laboratory test for diagnosing and determining the severity of sleep apnea. Recently, MPV, NLR, and PLR, known as the inflammatory markers in CBC test parameters, have been investigated in some studies. We aim to investigate whether these parameters could provide a method for diagnosing and determining the severity of OSAS in obese children. METHODS Clinical records of 180 patients were evaluated. All subjects had venous blood samples collected from the antecubital vein in the morning, after an overnight fasting, one day before PSG. Hemoglobin, RDW, MPV, PLT, platelet distribution width (PDW), and WBC count were measured. After anthropometric and laboratory analysis, 127 obese children were assessed for sleep study. Eighty-three patients who met the required polysomnographic criteria were divided into three groups as follows: group A [non-OSAS, apnea-plus-hypopnea index (AHI) < 1], groupB (1 ≤ AHI < 5), and groupC (AHI ≥ 5). RESULTS Total recording time, total sleep time, sleep efficiency, REM, and NREM sleep stage latency values were not statistically significant among groups. However, the number of awakenings, AHI, oxygen desaturation events, mean oxygen saturation, lowest oxygen saturation, average desaturation, and snoring time values had significant difference among the groups. There was no statistically significant difference among the groups in terms of WBC, Hemoglobin, platelets, PDW, neutrophil, and lymphocyte values. However, RDW values showed a statistically significant difference between groups A and C. Although there was no statistically significant difference of MPV values among groups, NLR and PLR values were statistically significant between groups A and C. CONCLUSION According to our study, NLR, PLR, and RDW were found to be significantly higher in children whose AHI was ≥5 than in children from the other groups. However, no correlation was found between MPV levels and OSAS in children.
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Affiliation(s)
- Ibrahim Erdim
- Department of Otolaryngology, Erbaa Government Hospital, Tokat, Turkey.
| | - Omer Erdur
- Department of Otolaryngology, Selcuk University, Konya, Turkey.
| | - Fatih Oghan
- Department of Otolaryngology, Dumlupinar University, Kutahya, Turkey.
| | - Fatih Mete
- Pediatric Clinic, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.
| | - Mustafa Celik
- Department of Otolaryngology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
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19
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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: 19] [Impact Index Per Article: 2.7] [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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20
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Association between mean platelet volume and hypertension incidence. Hypertens Res 2017; 40:779-784. [PMID: 28275234 DOI: 10.1038/hr.2017.30] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/08/2022]
Abstract
Mean platelet volume (MPV) is increased in various cardiovascular diseases. We sought to determine the prognostic value of MPV for hypertension. We performed a retrospective cohort study. Baseline characteristics were measured in 9168 individuals without hypertension, and the follow-up period was 9 years. Hypertension was confirmed in 2881 participants during the follow-up period. When the participants were grouped according to MPV quartiles, the hazard ratio of future hypertension gradually increased across the MPV quartiles. The hazard ratios of hypertension for the II, III and IV (high) vs. I (low) quartiles of MPV were 1.13 (95% confidence interval (CI) 1.01-1.25, P=0.027), 1.25 (95% CI 1.12-1.39, P<0.001) and 1.40 (95% CI 1.26-1.55, P<0.001), respectively. In multivariate Cox regression analysis, MPV predicted hypertension independently of age, sex, platelet count, waist circumference, drinking, systolic blood pressure and creatinine levels. The present study indicated that elevated MPV is associated with increased incidence of hypertension independent of other risk factors, which suggests that platelet activity may play a role in hypertension incidence.
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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.
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Shan LN, Chai WS, Lu SJ, Song YG, Su D, Yang S, Shi XB, Wang W. The significant effect of chronic intermittent hypoxia on prostaglandin D 2 biosynthesis in rat brain. Biochem Biophys Res Commun 2017; 483:283-287. [PMID: 28025147 DOI: 10.1016/j.bbrc.2016.12.151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/22/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Li-Na Shan
- Department of Respiratory, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121001, China
| | - Wen-Shu Chai
- Department of Respiratory, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121001, China
| | - Si-Jing Lu
- Department of Respiratory, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121001, China
| | - Yong-Gui Song
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China
| | - Dan Su
- National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China
| | - Shuman Yang
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Xian-Bao Shi
- Department of Respiratory, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121001, China.
| | - Wei Wang
- Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, China.
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Medium platelet volume as a noninvasive predictor of chronic total occlusion in non-infarct artery in patients with non-ST-segment elevation myocardial infarction and multivessel coronary artery disease. Int J Cardiol 2016; 228:594-598. [PMID: 27888750 DOI: 10.1016/j.ijcard.2016.11.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/05/2016] [Accepted: 11/10/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in non-ST elevation myocardial infarction (NSTEMI). Mean platelet volume (MPV) is associated with cardiovascular events in NSTEMI. Little is known about the predictors of non-IRA-CTO in patients with NSTEMI. The purpose of this study was to evaluate the relationship between the presence of non-IRA-CTO with MPV level in patients with NSTEMI and multivessel coronary artery disease (MVCAD). METHODS Data of consecutive patients with NSTEMI and MVCAD treated in high-volume PCI center between 2006 and 2012 and included in the prospective registry were divided according to the presence of CTO and analyzed. RESULTS In the group of 685 patients fulfilling the inclusion criteria, 308 (45%) patients had CTO (CTO+), and in 377 (55%) patients CTO was not observed (CTO-). The MPV level on admission was significantly higher in the CTO+ group than in the CTO- group (P<0.0001). In the multivariate analysis of the entire study population, independent predictors of occurrence of CTO were medium platelet volume (MPV; per 1fL more; odds ratio [OR] 1.34; 95% confidence interval [CI] 1.15-1.57; P=0.0002) together with left ventricular ejection fraction and prior MI. CONCLUSIONS MPV at admission is independently associated with more frequent occurrence of non-IRA CTO in patients with NSTEMI and MVCAD.
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Wasilewski J, Desperak P, Hawranek M, Ciślak A, Osadnik T, Pyka Ł, Gawlita M, Bujak K, Niedziela J, Krawczyk M, Gąsior M. Prognostic implications of mean platelet volume on short- and long-term outcomes among patients with non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: A single-center large observational study. Platelets 2016; 27:452-8. [PMID: 26939525 DOI: 10.3109/09537104.2016.1143919] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mean platelet volume (MPV) is a simple and reliable indicator of platelet size that correlates with platelet activation and their ability to aggregate. We studied the predictive value of MPV in patients with non-ST-segment elevation myocardial infarction (NSTEMI) treated with percutaneous coronary intervention (PCI). METHODS We analyzed the consecutive records of 1001 patients who were hospitalized due to NSTEMI at our center. The primary end point was a composite end point that included the rates of all-cause death, non-fatal myocardial infarction, and acute coronary syndrome (ACS) driven revascularization at 12 months. The enrolled patients were stratified according to the quartile of the MPV level at admission. RESULTS Along with the increasing quartile of MPV, the 12-month composite end point increased significantly (p = 0.010), and this association remained significant after the risk-adjusted analyses (per 1 fL higher MPV; adjusted hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.02-1.27; p = 0.026). In the multivariate analysis, the MPV was also an independent factor of all-cause mortality (per 1 fL increase; adjusted HR 1.34; 95% CI 1.12-1.61; p = 0.0014) and death or non-fatal myocardial infarction (per 1 fL increase; adjusted HR 1.16; 95% CI 1.03-1.31; p = 0.017). CONCLUSION In patients with NSTEMI treated with PCI, a high MPV value was associated with a significantly increased incidence of long-term adverse events, particularly for all-cause mortality.
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Affiliation(s)
- Jarosław Wasilewski
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Piotr Desperak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Hawranek
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Aneta Ciślak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Tadeusz Osadnik
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.,c Genomics Laboratory, Kardio-Med Silesia Science and Technology Park , Zabrze , Poland
| | - Łukasz Pyka
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Marcin Gawlita
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Kamil Bujak
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Jacek Niedziela
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Krawczyk
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Mariusz Gąsior
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
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The neutrophil-to-lymphocyte ratio in patients with obstructive sleep apnoea syndrome and its relationship with cardiovascular disease. Heart Lung 2016; 45:121-5. [DOI: 10.1016/j.hrtlng.2016.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 11/20/2022]
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The impact of chronic intermittent hypoxia on hematopoiesis and the bone marrow microenvironment. Pflugers Arch 2016; 468:919-32. [PMID: 26856724 PMCID: PMC4842224 DOI: 10.1007/s00424-016-1797-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/21/2015] [Accepted: 01/26/2016] [Indexed: 12/18/2022]
Abstract
Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder which is associated with patient morbidity and an elevated risk of developing hypertension and cardiovascular diseases. There is ample evidence for the involvement of bone marrow (BM) cells in the pathophysiology of cardiovascular diseases but a connection between OSA and modulation of the BM microenvironment had not been established. Here, we studied how chronic intermittent hypoxia (CIH) affected hematopoiesis and the BM microenvironment, in a rat model of OSA. We show that CIH followed by normoxia increases the bone marrow hypoxic area, increases the number of multipotent hematopoietic progenitors (CFU assay), promotes erythropoiesis, and increases monocyte counts. In the BM microenvironment of CIH-subjected animals, the number of VE-cadherin-expressing blood vessels, particularly sinusoids, increased, accompanied by increased smooth muscle cell coverage, while vWF-positive vessels decreased. Molecularly, we investigated the expression of endothelial cell-derived genes (angiocrine factors) that could explain the cellular phenotypes. Accordingly, we observed an increase in colony-stimulating factor 1, vascular endothelium growth factor, delta-like 4, and angiopoietin-1 expression. Our data shows that CIH induces vascular remodeling in the BM microenvironment, which modulates hematopoiesis, increasing erythropoiesis, and circulating monocytes. Our study reveals for the first time the effect of CIH in hematopoiesis and suggests that hematopoietic changes may occur in OSA patients.
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Altunayoglu Cakmak V, Ozsu S, Gulsoy A, Akpinar R, Bulbul Y. The Significance of the Relative Lymphocyte Count as an Independent Predictor of Cardiovascular Disease in Patients with Obstructive Sleep Apnea Syndrome. Med Princ Pract 2016; 25:455-60. [PMID: 27322584 PMCID: PMC5588447 DOI: 10.1159/000447697] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 06/19/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine whether or not relative lymphocyte count (RLC) is associated with cardiovascular disease (CVD) in patients with obstructive sleep apnea syndrome (OSAS). SUBJECTS AND METHODS In this study, 141 patients diagnosed with OSAS using polysomnography were enrolled. Patients were classified according to the severity of OSAS as determined by the apnea-hypopnea index (AHI) and presence of CVD. Lymphocyte count and other hematological parameters at complete blood count were determined and compared between patients with and without CVD. Multivariate regression analysis was used to estimate the associated factors for presence of CVD. RESULTS Absolute and relative lymphocyte counts were lower in the OSAS patients with CVD compared to those without CVD (mean absolute lymphocyte counts: 2.0 × 103 vs. 2.5 × 103 µl, p = 0.004, and mean RLC: 28.3 vs. 33.9%, p = 0.001, respectively). OSAS patients with CVD (14.2) had higher red cell distribution width values than the patients without CVD (13.4) (p = 0.005). Multivariate analysis identified RLC as an independent predictor of CVD in patients with OSAS (odds ratio = 0.9, 95% CI: 0.85-1.0, p = 0.042). CONCLUSION RLC was identified as an independent predictor of CVD in patients with OSAS. Since RLC is a widely available diagnostic tool with no additional costs over the routinely performed complete blood count, it can be used for predicting CVD in patients with OSAS.
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Affiliation(s)
- Vildan Altunayoglu Cakmak
- Department of Neurology, Trabzon, Turkey
- *Vildan Altunayoglu Cakmak, Department of Neurology, Faculty of Medicine, Karadeniz Technical University, Farabi Hospital street, TR—61080 Trabzon (Turkey), E-Mail
| | - Savas Ozsu
- Department of Pulmonary Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ayhan Gulsoy
- Department of Pulmonary Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | | | - Yilmaz Bulbul
- Department of Pulmonary Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Mean platelet volume is elevated in exacerbated and convalescent COPD patients. Clin Chim Acta 2015; 451:227-31. [DOI: 10.1016/j.cca.2015.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/20/2015] [Accepted: 10/01/2015] [Indexed: 11/18/2022]
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Saygin M, Ozturk O, Ozguner MF, Akkaya A, Varol E. Hematological Parameters as Predictors of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome Patients. Angiology 2015. [PMID: 26195559 DOI: 10.1177/0003319715595934] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We investigated the role of the red cell distribution width (RDW) and other parameters including platelet (PLT) count, mean platelet volume (MPV), and platelet distribution width (PDW) in patients with obstructive sleep apnea syndrome (OSAS) having cardiovascular diseases (CVDs). Patients (n = 142) having sleep disorders and who applied for a night polysomnography were included in this study. For statistical analysis, chi-square test, bivarite correlation, and logistic and stepwise regression tests were used. A positive correlation between RDW MPV, RDW, and body mass index as well as PLT and apnea-hypopnea index were observed. A negative correlation between AHI and PDW (P= .041) and a positive correlation between AHI and PLT (P= .010) were found in the patients ≥40 years old with CVD. The RDW was higher in patients ≥40 years old who had CVD (P= .016), and 19% of them had RDW >14%. The PDW (odds ratio = 6.02 [95% confidence interval = 1.3-28.2],P= .023) appeared to be associated with increased risk of hyperlipidemia in patients with severe OSAS. If these results are confirmed, RDW could be used with other markers, especially PLT and PDW, in prediction of CVD in patients with severe OSAS.
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Affiliation(s)
- Mustafa Saygin
- Department of Physiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey Center for Sleep Sciences and Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Onder Ozturk
- Center for Sleep Sciences and Medicine, Suleyman Demirel University, Isparta, Turkey Department of Chest Diseases, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Mehmet Fehmi Ozguner
- Department of Physiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey Center for Sleep Sciences and Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ahmet Akkaya
- Center for Sleep Sciences and Medicine, Suleyman Demirel University, Isparta, Turkey Department of Chest Diseases, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ercan Varol
- Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Akyol S, Çörtük M, Baykan AO, Kiraz K, Börekçi A, Şeker T, Gür M, Çayli M. Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome. Clinics (Sao Paulo) 2015; 70:481-5. [PMID: 26222817 PMCID: PMC4496750 DOI: 10.6061/clinics/2015(07)04] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/20/2015] [Accepted: 04/20/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Obstructive sleep apnea syndrome is associated with cardiovascular diseases and thromboembolic events. The mean platelet volume (MPV) is a predictor of cardiovascular thromboembolic events. The aim of the present study is to investigate the association between the MPV and disease severity in patients with obstructive sleep apnea syndrome. METHODS We prospectively included 194 obstructive sleep apnea syndrome patients without cardiovascular disease (mean age 56.5±12.5 years) who were undergoing sleep tests. An overnight full laboratory polisomnography examination was conducted on each patient. The patients were divided into 3 groups according to the apnea-hypopnea index (AHI): (1) AHIlow group: 5≤AHI<15, (2) AHImid group: 15 30. RESULTS The highest MPV values were found in the AHIhigh group compared with other groups (p<0.05 for all). Multiple linear regression analysis indicated that the MPV was associated with the AHI (β=0.500, p<0.001) and the high sensitivity C-reactive protein (hs-CRP) level (β=0.194, p=0.010). CONCLUSION The MPV is independently associated with both disease severity and inflammation in patients with obstructive sleep apnea syndrome.
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Affiliation(s)
- Selahattin Akyol
- Department of Cardiology, Adana Numune Training and Research Hospital, Çukurova/Adana, Turkey
| | - Mustafa Çörtük
- Department of Pulmonology, Adana Numune Training and Research Hospital, Çukurova/Adana, Turkey
| | - Ahmet Oytun Baykan
- Department of Cardiology, Adana Numune Training and Research Hospital, Çukurova/Adana, Turkey
| | - Kemal Kiraz
- Department of Pulmonology, Antalya Numune Training and Research Hospital, Turkey., Antalya
| | - Abdurrezzak Börekçi
- Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey
| | - Taner Şeker
- Department of Cardiology, Adana Numune Training and Research Hospital, Çukurova/Adana, Turkey
| | - Mustafa Gür
- Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey
| | - Murat Çayli
- Department of Cardiology, Adana Numune Training and Research Hospital, Çukurova/Adana, Turkey
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Impact of Multilevel Surgical Treatment on Mean Platelet Volume in Patients With Obstructive Sleep Apnea Syndrome. J Craniofac Surg 2015; 26:1287-9. [DOI: 10.1097/scs.0000000000001556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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A new ibuprofen derivative inhibits platelet aggregation and ROS mediated platelet apoptosis. PLoS One 2014; 9:e107182. [PMID: 25238069 PMCID: PMC4169656 DOI: 10.1371/journal.pone.0107182] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/06/2014] [Indexed: 12/17/2022] Open
Abstract
Thrombocytopenia is a serious issue connected with the pathogenesis of several human diseases including chronic inflammation, arthritis, Alzheimer's disease, cardiovascular diseases (CVDs) and other oxidative stress-associated pathologies. The indiscriminate use of antibiotics and other biological drugs are reported to result in thrombocytopenia, which is often neglected during the treatment regime. In addition, augmented oxidative stress induced by drugs and pathological conditions has also been shown to induce thrombocytopenia, which seems to be the most obvious consequence of elevated rate of platelet apoptosis. Thus, blocking oxidative stress-induced platelet apoptosis would be of prime importance in order to negotiate thrombocytopenia and associated human pathologies. The current study presents the synthesis and platelet protective nature of novel ibuprofen derivatives. The potent anti-oxidant ibuprofen derivative 4f was selected for the study and the platelet protective efficacy and platelet aggregation inhibitory property has been demonstrated. The compound 4f dose dependently mitigates the oxidative stress-induced platelet apoptosis in both platelet rich plasma and washed platelets. The platelet protective nature of compound 4f was determined by assessing various apoptotic markers such as ROS generation, cytosolic Ca2+ levels, PS externalization, cytochrome C translocation, Caspase activation, mitochondrial membrane depolarization, cytotoxicity, LDH leakage and tyrosine phosphorylation of cytosolic proteins. Furthermore, compound 4f dose dependently ameliorated agonist induced platelet aggregation. Therefore, compound 4f can be estimated as a potential candidate in the treatment regime of pathological disorders associated with platelet activation and apoptosis. In addition, compound 4f can be used as an auxiliary therapeutic agent in pathologies associated with thrombocytopenia.
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Mean platelet volume in patients with obstructive sleep apnea and its relationship with simpler heart rate derivatives. Cardiol Res Pract 2014; 2014:454701. [PMID: 25295213 PMCID: PMC4176644 DOI: 10.1155/2014/454701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/26/2014] [Accepted: 08/29/2014] [Indexed: 01/25/2023] Open
Abstract
Some studies show increased mean platelet volume (MPV) in obstructive sleep apnea (OSA). The aim of this study was to evaluate MPV in OSA patients without cardiovascular risk factors and the possible association of heart rate derivatives with MPV. A total of 82 patients (aged 30–70 years) were divided into 2 groups according to the presence of either OSA or non-OSA as the control group. The OSA group consisted of 52 patients and the control group consisted of 30 subjects. Neither group was significantly different in terms of MPV values as well as heart rate (HR) derivatives such as minimum HR, maximum HR, the difference between maximum HR and minimum HR, mean HR, and heart rate performance index (HRPI) [(HR max. − HR min.)/HR mean] (P > 0.05 for all variables). In multivariate analysis, platelet count and percentages of recording time spent at arterial oxygen saturation < 90% significant variables are associated with MPV (β ± SE: −0.004 ± 0.002, 95% CI, −0.008 to −0.001; P = 0.034) and (β ± SE: 2.93 ± 1.93, 95% CI, 0.167 to 5.69; P = 0.038). Consequently, our findings predominantly suggest that there is a casual and reciprocal interaction between MPV and autonomic activation.
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Feres MC, Cintra FD, Rizzi CF, Mello-Fujita L, Lino de Souza AA, Tufik S, Poyares D. Evaluation and validation of a method for determining platelet catecholamine in patients with obstructive sleep apnea and arterial hypertension. PLoS One 2014; 9:e98407. [PMID: 24911183 PMCID: PMC4049580 DOI: 10.1371/journal.pone.0098407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/02/2014] [Indexed: 11/23/2022] Open
Abstract
Background Measurements of plasma and urinary catecholamine are susceptible to confounding factors that influence the results, complicating the interpretation of sympathetic nervous system (SNS) activity in the Obstructive sleep apnea (OSA) and arterial hypertension (HYP) conditions. Objective In this study, we validated a test for platelet catecholamine and compared the catecholamine levels (adrenaline and noradrenaline) in urine, plasma and platelets in patients with OSA and HYP compared with controls. Methods In the validation, 30 healthy, nonsmoking volunteers who were not currently undergoing treatment or medication were selected as the control group. One hundred fifty-four individuals (114 OSA, 40 non-OSA) were consecutively selected from the outpatient clinic of the Sleep Institute and underwent clinical, polysomnographic and laboratory evaluation, including the urinary, plasma and platelet levels of adrenaline (AD) and noradrenaline (NA). Patients were then allocated to groups according to the presence of OSA and/or hypertension. Results A logistic regression model, controlled for age and BMI, showed that urinary AD and urinary NA were risk factors in the OSA+HYP group and the HYP group; however, the model showed higher levels of platelet NA for OSA without HYP. After 1 year of CPAP (continuous upper airway pressure) treatment, patients (n = 9) presented lower levels of urinary NA (p = 0.04) and platelet NA (p = 0.05). Conclusion Urinary NA and AD levels were significantly associated with the condition of hypertension with and without OSA, whereas platelet NA with OSA without comorbidity. These findings suggest that platelet catecholamine levels might reflect nocturnal sympathetic activation in OSA patients without hypertension.
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Affiliation(s)
- Marcia C. Feres
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
- * E-mail:
| | - Fatima D. Cintra
- Cardiology Department of Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Camila F. Rizzi
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
| | - Luciane Mello-Fujita
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
| | | | - Sergio Tufik
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
- Associação Fundo de Incentivo a Pesquisa – AFIP- São Paulo, São Paulo, SP, Brazil
| | - Dalva Poyares
- Psychobiology Department of Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
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Platelet-larger cell ratio and the risk of periprocedural myocardial infarction after percutaneous coronary revascularization. Heart Vessels 2013; 30:20-7. [PMID: 24297745 DOI: 10.1007/s00380-013-0449-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/15/2013] [Indexed: 10/26/2022]
Abstract
Periprocedural myocardial infarction (PMI) represents a frequent complication in patients undergoing percutaneous coronary revascularization. Despite great attention focused on pharmacological prevention of periprocedural damage, very little is known about using biomarkers to potentially predict the risk of PMI. Larger platelets have been associated with enhanced reactivity, increased cardiovascular risk, and higher rates of complications after coronary stenting. The platelet-larger cell ratio (P-LCR) identifies the largest-sized fraction of platelets, the proportion potentially more closely related to thrombotic events. The present study evaluated the relationship between P-LCR and PMI. We included 1,285 patients undergoing PCI. Myonecrosis biomarkers were dosed at intervals from 6 to 48 h after PCI. Periprocedural myonecrosis was defined as troponin I increase by three times the upper limit of normal (ULN) or by 50 % of an elevated baseline value, whereas PMI was defined as an increase in creatine kinase MB by 3 × ULN or 50 % of baseline. We grouped patients according to tertile values of P-LCR (<27.5; ≥35.1). Higher P-LCR was associated with age (P = 0.01), diabetes (P = 0.001), previous cerebrovascular accidents (P = 0.007), therapy with statins (P < 0.001), angiotensin receptor blockers (P < 0.001), aspirin (P = 0.002), and nitrates (P = 0.01). P-LCR was related to hemoglobin levels (P < 0.001), and inversely related to platelet count (P < 0.001) and glycemia (P = 0.05). Patients with higher P-LCR had a lower presence of coronary thrombus (P = 0.003). Higher P-LCR values did not increase the risk of PMI (P = 0.10; adjusted odds ratio (OR) (95 % confidence interval (CI)) = 0.97 (0.69-1.38)), P = 0.89) or periprocedural myonecrosis (P = 0.96; adjusted OR (95 % CI) = 1.003 (0.76-1.32), P = 0.99). Results were confirmed even in higher-risk subgroups of patients. P-LCR does not increase the risk of periprocedural myocardial infarction and myonecrosis in patients undergoing coronary stenting.
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