Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for the development of cardiovascular events and hypertension. Mean platelet volume (MPV), an indicator of platelet activation and aggregation, is closely related with cardiovascular diseases (CVDs). We aimed to show the relationship between OSAS and MPV with CVD. The medical records of 205 patients who were admitted to the sleep study were evaluated. OSAS was diagnosed by polysomnography if the apnea-hypopnea index (AHI) was greater than 5. MPV was calculated from blood samples. According to AHI, individuals in whom AHI was less than 5 were recruited as the control group, those in whom AHI was 5-15 as the mild OSAS group, those in whom AHI was equal to 15-30 as the moderate OSAS group, and those in whom AHI was greater than 30 as the severe OSAS group. Of the patients, 137 (67%) were men and 68 (33%) were women; the mean age was 53.0±14.1 years. There were 35 (17%), 20 (10.2%), 42 (20.4%), and 108 (52.6%) participants in groups 1, 2, 3, and 4, respectively. There were significant differences in terms of coronary artery disease and hypertension between all groups (P<0.05). There was a significant association between the severity of OSAS and MPV in groups 3 and 4, whereas there was not any association in groups 1 and 2 (group 1=9.3±0.7, group 2=9.4±0.8, group 3=9.5±1.1, group 4=10.2±1.2; P for trend 0.03). We showed that MPV was significantly increased in patients with OSAS, which is an independent risk factor for CVD. Therefore, MPV could be used as a marker to predict CVD in OSAS.

In the light of the present study, we speculate that OSAS is an independent risk factor for the progression of chronic kidney disease, which is a growing health problem. Further randomized-multicenter prospective studies are warranted to evaluate this relationship.

Gamma glutamyl transferase (GGT) is a new marker for predicting myocardial infarction, stroke, cardiac death and inflammation. There is also a strong relationship between Obstructive Sleep Apnea Syndrome (OSAS) and cardiovascular disease. This study was designed to investigate the association between serum GGT levels and cardiovascular disease in patients with OSAS, and relationship between severity of OSAS and serum GGT level. We evaluated the medical records of 166 subjects who were admitted for sleep study. OSAS was diagnosed by polysomnography if Apnea-Hypopnea Index (AHI) > 5. According to AHI, individuals in whom AHI< 5 were recruited as group 1 (OSAS negative group), AHI = 5-15: group 2 (mild OSAS group), AHI = 15-30: group 3 (moderate OSAS group), AHI >30: group 4 (severe OSAS group). Cardiovascular disease was defined if the patients had heart failure, coronary artery disease or arrhythmia. Of the subjects, 112 (67.5%) were male and the mean age was 54.3 ± 12.2 years. There were 22 patients (13.2%), 17 patients (10.2%), 34 patients (20.4%) and 93 patients (56.2%) in group 1, 2, 3 and 4, respectively. There is a significant increase in serum GGT levels while AHI score increases (group 1 = 28.0 ± 10.1, group 2 = 33.8 ± 13.2, group 3 = 35.2 ± 8.5, group 4 = 40.0 ± 22.0; p for trend = 0.024). However, serum C-reactive protein (CRP), alanine aminotransferase and aspartate aminotransferase levels were similar in all groups (p > 0.05). There was a significant independent association between serum GGT levels and the severity of OSAS. Moreover, serum GGT levels were significantly high in patients with cardiovascular disease compared with patients without cardiovascular disease in severe-moderate-mild OSAS (p < 0.05) and OSAS negative groups while CRP levels were not. This was a significant independent association. The present study suggests that high serum GGT level, regardless of the other traditional risk factors, is an independent predictor of cardiovascular disease in patients with OSAS. The results should be confirmed with other randomized prospective studies.

In conclusion, there was no difference between smoking-related COPD and the control group according to TNF α-308 gene polymorphism in a Caucasian population. In addition, it was shown that important determinants of prognosis of COPD such as FEV1, BMI, COPD exacerbation and hospitalization were not associated with TNF-α-308 gene polymorphism.

Introduction: Some conflicting results have been published about the relationship between TNF-␣-308 gene polymorphism and chronic obstructive pulmonary disease (COPD). The aim of this study was to determine whether TNF-␣-308 gene polymorphism was associated with smokingrelated COPD and whether it was associated with pulmonary function parameters (PFTs), body mass index (BMI), and prognosis. Methods: We studied the frequencies of TNF-␣-308 gene polymorphism in 90 male subjects (60 subjects with COPD and 30 healthy smokers) in a Caucasian population. Estará o polimorfismo do gene TNF-␣ relacionado com a função pulmonar e o prognóstico determinados pelo VEMS, IMC, exacerbações e hospitalizações em doentes com DPOC associados ao tabagismo numa população turca?Resumo Introdução: Foram publicados alguns resultados contraditórios sobre a relação entre o polimorfismo do gene TNF-␣ -308 e a doença pulmonar obstrutiva crónica (DPOC). O objectivo deste estudo foi determinar se o polimorfismo do gene TNF-␣ -308 estava associado à DPOC ligada ao tabagismo e se foi associado aos parâmetros de função pulmonar (PFTs), índice de massa corporal (IMC), e prognóstico. Métodos: Estudámos as frequências do polimorfismo do gene TNF-␣ -308 em 90 indivíduos do sexo masculino (60 indivíduos com DPOC e 30 fumadores saudáveis) numa população caucasiana. Resultados: Não houve uma diferença significativa na frequência de polimorfismos genéticos G/G e G/A no grupo de DPOC, em comparação com o grupo de controlo (p>0,05). Comparámos os doentes com DPOC como polimorfismo genético G/A e polimorfismo genético G/G; os PFTs (parâmetros de função pulmonar) e o IMC (índice de massa corporal) antes e depois de um ano não eram estatisticamente significativos (p>0,05). Da mesma forma, os dados de agravamento e hospitalização dos doentes com DPOC não eram significativos entre estes grupos. Conclusão: Em conclusão, não existiu uma diferença entre o grupo com DPOC ligada ao tabagismo e o grupo de controlo, de acordo com o polimorfismo do gene TNF ␣ -308, numa população caucasiana. Além disso, foi mostrado que determinantes importantes do prognóstico da DPOC, tal como VEMS, IMC, exacerbações da DPOC e hospitalização não estavam associados ao polimorfismo do gene TNF-␣ -308.