Can biomarkers predict the risk of cardiovascular disease in patients with obstructive sleep apnea syndrome? Biomarkers in obstructive sleep apnea syndrome

Hasan Ölmez; Mustafa  Tosun; Edhem  Ünver; Reşit Çoşkun; Gönül Seven  Yalçın; Mehmet  Doğan; Yusuf Kemal  Arslan

doi:10.28982/josam.7716

Authors

Hasan Ölmez Department of Chest Diseases, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey https://orcid.org/0000-0003-4153-9953
Mustafa Tosun Department of Chest Diseases, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey https://orcid.org/0000-0002-5204-2099
Edhem Ünver Department of Chest Diseases, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey https://orcid.org/0000-0002-0322-8102
Reşit Çoşkun Department of Cardiology, Faculty of Medicine Erzincan Binali Yildirim University, Erzincan, Turkey https://orcid.org/0000-0002-0312-2009
Gönül Seven Yalçın Department of Pulmonary Diseases, Göztepe Prof. Dr. Süleyman Yalçın City Hospital Istanbul, Turkey https://orcid.org/0000-0002-7751-3774
Mehmet Doğan Departmet of Pulmoner Disease, Kütahya University of Health Sciences, Kütahya, Turkey https://orcid.org/0000-0003-0144-962X
Yusuf Kemal Arslan Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey https://orcid.org/0000-0003-1308-8569

DOI:

https://doi.org/10.28982/josam.7716

Keywords:

OSAS, cardiovascular disease, biomarker, AHI

Abstract

Background/Aim: Obstructive sleep apnea syndrome (OSAS) is a clinical syndrome characterized by recurrent partial or total obstruction of the upper airway. Cardiovascular disease (CVD) is more common in OSAS patients. Biomarkers can predict the progression of OSAS disease and the occurrence of CVD. Here we investigate the effects of age, gender, body mass index (BMI), comorbidities, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), atherogenic index of plasma (AIP), C-reactive protein-to-albumin ratio (CAR) and monocyte to HDL cholesterol (MHR) on the severity of OSAS and the occurrence of CVD in OSAS patients.

Method: This cross-sectional study included 172 OSAS patients presenting to Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital, Sleep Service between 01.01.2021 and 31.08.2022. Polysomnography (PSG) was applied to patients participating in the study, and routine complete blood and biochemistry tests were performed. Comorbidities and demographic data of the participants were recorded.

Results: The frequency of CVD, chronic pulmonary disease (CPD) and hyperlipidemia increased as the severity of OSAS increased (P=0.005, P<0.001, P=0.016, respectively). As the severity of OSAS disease increased, only the MHR indices increased (P=0.009). When OSAS groups with and without CVD were examined, OSAS patients with CVD were older and had higher BMI (P<0.001, P=0.001, respectively). In addition, tended to be females with hyperlipidemia, diabetes mellitus (DM) and high Charlson Comorbidity Index (CCI) scores (all P<0.001). When the polysomnography of OSAS patients with CVD was evaluated, apnea-hypopnea index (AHI), non-rapid eye movement (NREM)-AHI (NREM-AHI), respiratory disorder index (RDI) and oxygen desaturation index (ODI) values were higher and sleep efficiency (SE) values were lower than patients with OSAS without CVD (P=0.002, P=0.002, P=0.003, P<0.001, P<0.001, respectively).

Conclusion: CVD is common in OSAS patients. As the severity of OSAS increases, the risk of developing CVD increases. Elderly female OSAS patients with hyperlipidemic, DM, high BMI, and Charlson Comorbidity Index (CCI) constitute a relatively risky group for CVD. OSAS patients with high AHI, NREM-AHI, RDI, ODI, and low SE values should be monitored more closely for CVD.

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