Hostname: page-component-6766d58669-h8lrw Total loading time: 0 Render date: 2026-05-21T07:06:57.315Z Has data issue: false hasContentIssue false
  • English
  • Français

Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome

Published online by Cambridge University Press:  03 August 2015

A Yenigun  and
H Karamanli
A Yenigun*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
H Karamanli
Affiliation:
Department of Respiratory Medicine, Faculty of Medicine, Mevlana University, Konya, Turkey
*
Address for correspondence: Dr Alper Yenigun, Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı Vatan Caddesi, 34093 Fatih/İstanbul, Turkey Fax: +90 (212) 453 18 70 E-mail: alperyenigun@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate the neutrophil-to-lymphocyte ratio and sleep apnoea severity relationship.

Methods:

Patients (n = 178) were assigned to five groups according to apnoea–hypopnea indices and continuous positive airway pressure use. White blood cell, neutrophil, lymphocyte and neutrophil-to-lymphocyte ratio values were compared for each group.

Results:

The neutrophil-to-lymphocyte ratio values of severe obstructive sleep apnoea syndrome patients (group 4) were significantly higher than those of: control patients (group 1), mild obstructive sleep apnoea syndrome patients (group 2) and patients treated with continuous positive airway pressure (group 5) (p = 0.008, p = 0.008 and p = 0.003). Minimum oxygen saturation values of group 4 were significantly lower than those of groups 1, 2 and 5 (p = 0.0005, p = 0.011 and p = 0.001). There was a positive correlation between apnoea–hypopnea index and neutrophil-to-lymphocyte ratio (r = 0.758, p = 0.034), and a negative correlation between apnoea–hypopnea index and minimum oxygen saturation (r = −0.179, p = 0.012).

Conclusion:

Neutrophil-to-lymphocyte ratio may be used to determine disease severity, complementing polysomnography.

Keywords

NeutrophilsLymphocytesSleep ApneaObstructive Sleep Apnea SyndromeUpper Airway Resistance Sleep Apnea Syndrome

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 9 , September 2015 , pp. 887 - 892
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Garvey, JF, Taylor, CT, McNicholas, WT. Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation. Eur Respir J 2009;33:1195–205CrossRefGoogle ScholarPubMed
2Andrews, JG, Oei, TP. The roles of depression and anxiety in the understanding and treatment of obstructive sleep apnea syndrome. Clin Psychol Rev 2004;24:1031–49CrossRefGoogle ScholarPubMed
3Kushida, CA, Littner, MR, Morgenthaler, T, Alessi, CA, Bailey, D, Coleman, J Jr et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 2005;28:499–521CrossRefGoogle ScholarPubMed
4Marin, JM, Carrizo, SJ, Vicente, E, Agusti, AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046–53CrossRefGoogle ScholarPubMed
5Kusumanto, YH, Dam, WA, Hospers, GA, Meijer, C, Mulder, NH. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 2003;6:283–7CrossRefGoogle ScholarPubMed
6Guthrie, GJ, Charles, KA, Roxburgh, CS, Horgan, PG, McMillan, DC, Clarke, SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol 2013;88:218–30CrossRefGoogle ScholarPubMed
7Tamhane, UU, Aneja, S, Montgomery, D, Rogers, EK, Eagle, KA, Gurm, HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653– 7CrossRefGoogle ScholarPubMed
8Rechtschaffen, A, Kales, A. A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages in Human Subjects. Los Angeles: Brain Information Service VCLA, 1968Google Scholar
9Gould, GA, Whyte, KF, Rhind, GB, Airlie, MA, Catterall, JR, Shapiro, CM et al. The sleep hypopnea syndrome. Am Rev Respir Dis 1988;137:895–8CrossRefGoogle ScholarPubMed
10Mehra, R, Redline, S. Sleep apnea: a proinflammatory disorder that coaggregates with obesity. J Allergy Clin Immunol 2008;121:1096–102CrossRefGoogle ScholarPubMed
11Nadeem, R, Molnar, J, Madbouly, EM, Nida, M, Aggarwal, S, Sajid, H et al. Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med 2013;9:1003–12CrossRefGoogle ScholarPubMed
12Guven, SF, Turkkani, MH, Ciftci, B, Ciftci, TU, Erdogan, Y. The relationship between high-sensitivity C-reactive protein levels and the severity of obstructive sleep apnea. Sleep Breath 2012;16:217–21CrossRefGoogle ScholarPubMed
13Williams, A, Scharf, SM. Obstructive sleep apnea, cardiovascular disease, and inflammation--is NF-kappa B the key? Sleep Breath 2007;11:69–76CrossRefGoogle ScholarPubMed
14Poyton, RO, Ball, KA, Castello, PR. Mitochondrial generation of free radicals and hypoxic signaling. Trends Endocrinol Metab 2009;20:332–40CrossRefGoogle ScholarPubMed
15Dai, R, Phillips, RA, Ahmed, SA. Despite inhibition of nuclear localization of NF-kappa B p65, c-Rel, and RelB, 17-beta estradiol up-regulates NF-kappa B signaling in mouse splenocytes: the potential role of Bcl-3. J Immunol 2007;179:1776–83CrossRefGoogle ScholarPubMed
16Dyugovskaya, L, Lavie, P, Lavie, L. Phenotypic and functional characterization of blood γδ T cells in sleep apnea. Am J Respir Crit Care Med 2003;168:242–9CrossRefGoogle ScholarPubMed
17Yokoe, T, Minoguchi, K, Matsuo, H, Oda, N, Minoguchi, H, Yoshino, G et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation 2003;107:1129–34CrossRefGoogle ScholarPubMed
18Arruda-Olson, AM, Reeder, GS, Bell, MR, Weston, SA, Roger, VL. Neutrophilia predicts death and heart failure after myocardial infarction: a community-based study. Circ Cardiovasc Qual Outcomes 2009;2:656–62CrossRefGoogle ScholarPubMed
19Rudiger, A, Burckhardt, OA, Harpes, P, Muller, SA, Follath, F. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med 2006;24:451–4CrossRefGoogle ScholarPubMed
20Akpek, M, Kaya, MG, Lam, YY, Sahin, O, Elcik, D, Celik, T et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol 2012;110:621–7CrossRefGoogle ScholarPubMed
21Li, MX, Liu, XM, Zhang, XF, Zhang, JF, Wang, WL, Zhu, Y et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer 2014;134:2403–13CrossRefGoogle ScholarPubMed
22Duffy, BK, Gurm, HS, Rajagopal, V, Gupta, R, Ellis, SG, Bhatt, DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006;97:993–6CrossRefGoogle ScholarPubMed
23Gibson, PH, Croal, BL, Cuthbertson, BH, Small, GR, Ifezulike, AI, Gibson, G et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995–1002CrossRefGoogle ScholarPubMed
24Turkmen, K, Guney, I, Yerlikaya, FH, Tonbul, HZ. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail 2012;34:155–9CrossRefGoogle ScholarPubMed