Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 17;23(20):12431.
doi: 10.3390/ijms232012431.

CPAP Influence on Readily Available Inflammatory Markers in OSA-A Pilot Study

Ioana Madalina Zota  1 , Cristina Andreea Adam  1 , Dragoș Traian Marius Marcu  1 , Cristian Stătescu  1 , Radu Sascău  1 , Larisa Anghel  1 , Daniela Boișteanu  2 , Mihai Roca  1 , Corina Lucia Dima Cozma  1 , Alexandra Maștaleru  1 , Maria Magdalena Leon Constantin  1 , Elena Andreea Moaleș  2 , Florin Mitu  1
Affiliations

CPAP Influence on Readily Available Inflammatory Markers in OSA-A Pilot Study

Ioana Madalina Zota et al. Int J Mol Sci. .

Abstract

Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse, chronic hypoxia and a proinflammatory phenotype. The purpose of our study was to evaluate readily available inflammatory biomarkers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), WBC-to-MPV ratio (WMR) and lymphocyte-to-C-reactive protein ratio (LCR)) before and after CPAP in patients with moderate-severe OSA. We performed a prospective study that included patients with newly-diagnosed moderate-severe OSA. The control groups (patients without OSA and with mild OSA) were selected from the hospital polygraphy database. All subjects underwent routine blood panel, which was repeated in moderate-severe OSA patients after 8 weeks of CPAP. Our final study group included 31 controls, 33 patients with mild, 22 patients with moderate and 37 patients with severe OSA. CRP, ESR, NLR and WMR were correlated with OSA severity. After 8-week CPAP therapy, we documented a decrease in weight status, which remained statistically significant in both CPAP-adherent and non-adherent subgroups. Readily available, inexpensive inflammatory parameters can predict the presence of moderate-severe OSA, but are not influenced by short-term CPAP.

Keywords: C-reactive protein (CRP); continuous positive airway pressure (CPAP); inflammation; neutrophil-to-lymphocyte ratio (NLR); obstructive sleep apnea (OSA); platelet-to-lymphocyte ratio (PLR); red cell distribution width (RDW).

PubMed Disclaimer

Conflict of interest statement

M.R. and D.B. have received financial support for conference attendance from Linde Gas and Vital Aire.

Figures

Figure 1
Figure 1
Correlations between AHI and inflammatory markers (123 patients, controls and OSA) (AHI: apnea–hypopnea index, NLR: neutrophil–lymphocyte ratio, LCR: lymphocyte-to-C-reactive protein ratio, RDW: red cell distribution width).
Figure 2
Figure 2
Correlations between AHI and inflammatory markers (123 patients, controls and OSA) (AHI: apnea–hypopnea index, MPV: mean platelet volume, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate).
Figure 3
Figure 3
Impact of inflammatory parameters in predicting moderate–severe OSA (NLR: neutrophil-lymphocyte ratio; WMR: white blood cell count-to-mean platelet volume ratio; LCR: lymphocyte-to-CRP ratio; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; PLR: platelet-to-lymphocyte ratio; RDW: red cell distribution width; MPV: mean platelet volume).
Figure 4
Figure 4
Impact of inflammatory parameters in predicting severe OSA (NLR: neutrophil–lymphocyte ratio; WMR: white blood cell count-to-mean platelet volume ratio; LCR: lymphocyte-to-CRP ratio; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; PLR: platelet-to-lymphocyte ratio; RDW: red cell distribution width; MPV: mean platelet volume).
Figure 5
Figure 5
Inflammatory parameters with a predictive role for CPAP adherence in patients with moderate OSA (NLR: neutrophil–lymphocyte ratio; WMR: white blood cell count-to-mean platelet volume ratio; LCR: lymphocyte-to-CRP ratio; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; PLR: platelet-to-lymphocyte ratio; RDW: red cell distribution width; MPV: mean platelet volume).
Figure 6
Figure 6
Inflammatory parameters with a predictive role for CPAP adherence in patients with severe OSA (NLR: neutrophil–lymphocyte ratio; WMR: white blood cell count-to-mean platelet volume ratio; LCR: lymphocyte-to-CRP ratio; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; PLR: platelet-to-lymphocyte ratio; RDW: red cell distribution width; MPV: mean platelet volume).
See this image and copyright information in PMC

References

    1. Young T., Palta M., Dempsey J., Skatrud J., Weber S., Badr S. The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults. N. Engl. J. Med. 1993;328:1230–1235. doi: 10.1056/NEJM199304293281704. - DOI - PubMed
    1. Heinzer R., Vat S., Marques-Vidal P., Marti-Soler H., Andries D., Tobback N., Mooser V., Preisig M., Malhotra A., Waeber G., et al. Prevalence of Sleep-Disordered Breathing in the General Population: The HypnoLaus Study. Lancet Respir. Med. 2015;3:310–318. doi: 10.1016/S2213-2600(15)00043-0. - DOI - PMC - PubMed
    1. Liu X., Ma Y., Ouyang R., Zeng Z., Zhan Z., Lu H., Cui Y., Dai Z., Luo L., He C., et al. The Relationship between Inflammation and Neurocognitive Dysfunction in Obstructive Sleep Apnea Syndrome. J. Neuroinflammation. 2020;17:229. doi: 10.1186/s12974-020-01905-2. - DOI - PMC - PubMed
    1. Jullian-Desayes I., Joyeux-Faure M., Tamisier R., Launois S., Borel A.-L., Levy P., Pepin J.-L. Impact of Obstructive Sleep Apnea Treatment by Continuous Positive Airway Pressure on Cardiometabolic Biomarkers: A Systematic Review from Sham CPAP Randomized Controlled Trials. Sleep Med. Rev. 2015;21:23–38. doi: 10.1016/j.smrv.2014.07.004. - DOI - PubMed
    1. Song S.O., He K., Narla R.R., Kang H.G., Ryu H.U., Boyko E.J. Metabolic Consequences of Obstructive Sleep Apnea Especially Pertaining to Diabetes Mellitus and Insulin Sensitivity. Diabetes Metab. J. 2019;43:144–155. doi: 10.4093/dmj.2018.0256. - DOI - PMC - PubMed