J Sleep Med.  2018 Jun;15(1):20-26. 10.13078/jsm.18008.

Hematologic Markers as a Predictive Factor for Moderate to Severe Obstructive Sleep Apnea Syndrome in Children and Adolescents

• Kim SS
• Yang KI

• KMID: 2434753
• DOI: http://doi.org/10.13078/jsm.18008

Abstract

OBJECTIVES
We conducted this study to evaluate the diagnostic value of hematologic markers for moderate to severe obstructive sleep apnea syndrome (OSAS).
METHODS
We performed the study using medical records from our sleep disorders center. We collected information regarding obstructive apnea-hypopnea index (oAHI), age, sex, body mass index, and complete blood counts with differential counts [white blood cell (WBC) count, neutrophil count, lymphocyte count, red blood cell distribution width (RDW), mean platelet volume, platelet count, platelet distribution width (PDW), neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio]. We excluded patients who were younger than 2 years, older than 14 years, obese/underweight, and those who had a hematologic or severe medical illness.
RESULTS
We assessed records from 57 patients (7.98±3.25 years old, 35 men). We classified the subjects into three groups based on their oAHI scores, as follows: normal (oAHI < 1), mild OSAS (1≤oAHI < 5), and moderate/severe OSAS (oAHI≥5). Using a multivariate multinomial logistic regression model (pseudo R²=0.33), we found significant differences among the groups in RDW [moderate/severe OSAS vs. mild OSAS, adjusted odds ratio (OR): 8.77, p-value: 0.03], PDW (mild OSAS vs. normal, adjusted OR: 1.05, p-value: 0.04), and WBC (moderate/severe OSAS vs. normal, adjusted OR: 1.42, p-value: 0.03).
CONCLUSIONS
RDW, PDW, and WBC had diagnostic value for moderate/severe OSAS in our study. Further prospective and validation studies are required to develop a screening tool for moderate/severe OSAS in children and adolescents.

Keyword

Children; Sleep apnea syndrome; Red cell distribution width; Platelet distribution width

MeSH Terms

Adolescent*
Blood Cell Count
Blood Cells
Blood Platelets
Body Mass Index
Child
Erythrocyte Indices
Erythrocytes
Humans
Logistic Models
Lymphocyte Count
Mass Screening
Mean Platelet Volume
Medical Records
Neutrophils
Odds Ratio
Platelet Count
Prospective Studies
Sleep Apnea Syndromes
Sleep Apnea, Obstructive*
Sleep Wake Disorders