Correlation of changes in the red blood cell distribution width with the response to continuous positive airway pressure in patients with obstructive sleep apnea
- 71 Downloads
It is recently found that the red blood cell distribution width (RDW) is independently associated with cardiovascular disease in patients with obstructive sleep apnea (OSA).The goal of this study is to investigate the correlation of RDW with the severity of OSA and whether RDW could be used to monitor the response to continuous positive airway pressure (CPAP) therapy in OSA patients. The study enrolled 70 participants. Control group (n = 24) consisted of patients with normal polysomnography and OSA group (n = 46) comprised patients with OSA of varying severity. RDW was measured before polysomnography in both groups. In addition, RDW was measured in the OSA group following 3 months of CPAP therapy. The RDW was significantly higher in the OSA group (p < 0.001), and this difference remained after adjusting for age and body mass index (p = 0.001). The RDW was approximately twofold greater in the OSA group (OR 2.126, 95% confidence interval 1.32–3.41; p = 0.002). On univariate analysis, the RDW was significantly correlated with hypoxia parameters, which was persistent with multivariate analysis. Furthermore, CPAP therapy reduced RDW (p = 0.002), and the change in the severity of 3% ODI by CPAP was correlated with the change in the RDW (r = 0.416, p = 0.013). The high RDW may be related to the pathophysiology of OSA. The high RDW in OSA may be associated with hypoxia. Therefore, treating OSA with CPAP could improve the RDW.
KeywordsSleep-disordered breathing Respiratory disease Hypoxia Hematology Erythrocyte index
HL and TK conceived and designed the study, acquired the data, and wrote the manuscript. AYA critically revised the manuscript and contributed important intellectual content.
No funding was received for this research.
Compliance with ethical standards
Conflict of interest
Lakadamyali H. declares that he has no conflict of interest. Kivanc T. declares that he has no conflict of interest. Yilmaz Avci A. declares that she has no conflict of interest.
This study was approved by Ministry of Health Research and Training Center Clinical Research Ethical Committee approval number 2015-110 and conducted in accordance with Declaration of Helsinki 1964.
Informed consent was obtained from all participants included in the study.
- 5.Ciccone MM, Scicchitano P, Zito A, Cortese F, Boninfante B, Falcone VA, Quaranta VN, Ventura VA, Zucano A, Di Serio F, Damiani MF, Resta O. Correlation between inflammatory markers of atherosclerosis and carotid intima–media thickness in obstructive sleep apnea. Molecules. 2014. https://doi.org/10.3390/molecules19021651.Google Scholar
- 7.Perkins SL. Examination of blood and bone marrow. In: Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraksevas F, Glader BE, editors. Wintrobe’s clinical hematology. 11th ed. Utah: Lippincott Wilkins & Williams; 2003. pp. 5–25.Google Scholar
- 8.Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, Swedberg K, Wang D, Yusuf S, Michelson EL, Granger CB, CHARM investigators. Red blood cell distribution width as a novel prognostic factor in heart failure: data from the CHARM program and the Duke databank. J Am Coll Cardiol. 2007. https://doi.org/10.1016/j.jacc.2007.02.067.Google Scholar
- 10.Drakopoulou M, Toutouzas K, Stefanadi E, Tsiamis E, Tousoulis D, Stefanadis C. Association of inflammatory markers with angiographic severity and extent of coronary artery disease. Atherosclerosis. 2009. https://doi.org/10.1016/j.atherosclerosis.2009.01.041.Google Scholar
- 11.Tonelli M, Sacks F. Arnold M, Moye L, Davis B, Pfeffer M, Cholesterol and Recurrent Events (CARE) Trial Investigators. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation. 2008. https://doi.org/10.1161/circulationaha.107.727545.Google Scholar
- 16.Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra M, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM. American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American academy of sleep medicine. J Clin Sleep Med. 2012. https://doi.org/10.5664/jcsm.2172.Google Scholar
- 17.Flemons WW, Buysse D, Redline S, Pack A, Strohl K, Wheatley T, Young T, Douglas N, Levy P, McNicholas W, Fleetham J, White D, Schmidt-Nowarra W, Carley D, Romaniuk J. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–89.CrossRefGoogle Scholar