Blood count values and ratios for predicting sleep apnea in obese children

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.

Keywords: Blood values; Obese children; Obstructive Sleep Apnea Syndrome (OSAS).