The novel indicators of moderate to severe sleep apnea: fibrinogen to albumin ratio vs. CRP to albumin ratio

  • Omer Hizli
  • Serkan Cayir
  • Yonca Coluk
  • Serkan KayabasiEmail author
  • Guven Yildirim
Head and Neck
Part of the following topical collections:
  1. Sleep Apnea Syndrome: From the pathogenesis to the last therapies



This study aimed at investigating the association of severity of obstructive sleep apnea with the markers of inflammation as fibrinogen to albumin ratio and C-reactive protein to albumin ratio.


We included 126 patients admitted to sleep disorders outpatient clinic. We constituted four groups by reference to the apnea–hypopnea index (mild-moderate-severe sleep apnea and control group). We investigated the difference of white blood cell, fibrinogen to albumin ratio, C-reactive protein to albumin ratio, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and hemoglobin among the groups.


Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and hemoglobin did not significantly differ among four groups (p = 0.39, p = 0.06, and p = 0.31, respectively). A significant difference of fibrinogen to albumin ratio and C-reactive protein to albumin ratio was evident among four groups (p < 0.001). Fibrinogen to albumin ratio and C-reactive protein to albumin ratio did not significantly differ between the mild sleep apnea and control groups (p = 0.65, and p = 0.85, respectively), but were significantly greater in moderate sleep apnea group compared with the control group (p < 0.001 and p = 0.001, respectively). Also, fibrinogen to albumin ratio and C-reactive protein to albumin ratio were significantly greater in the severe sleep apnea group compared with the control group (p < 0.001). Fibrinogen to albumin ratio and C-reactive protein to albumin ratio did not significantly differ between the severe sleep apnea and moderate sleep apnea groups (p = 0.49, and p = 0.58, respectively).


Higher fibrinogen to albumin ratio and C-reactive protein to albumin ratio may be predictive of inflammation in patients with moderate-to-severe sleep apnea.


Sleep apnea Fibrinogen C-reactive protein Albumin 



The authors declared that this study has received no financial support.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of local ethical committee of Giresun University (IRB Number: 90139838-000-E.44913).

Informed consent

Informed consent was obtained from the participants.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of ENTGiresun University, Prof Dr. A. Ilhan Ozdemir Education and Research HospitalGiresunTurkey
  2. 2.Department of ENTAksaray University, Aksaray Education and Research HospitalAksarayTurkey
  3. 3.Department of ENTGiresun University, Faculty of MedicineGiresunTurkey
  4. 4.Department of ENTAksaray University, Faculty of MedicineAksarayTurkey

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