Neutrophil-to-Lymphocyte Ratio Facilitates Identification of Obstructive Sleep Apnea in Patients with Type B Aortic Dissection

Abstract

Purpose. To determine whether the neutrophil-to-lymphocyte ratio (NLR) aids in the detection of obstructive sleep apnea (OSA) in patients with type B aortic dissection (TBAD). Methods. 324 patients with TBAD or type B aortic intramural hematoma (TB-AIMH) underwent an overnight sleep study. We divided the eligible 256 studied subjects into three groups: group A (n = 109, TBAD patients with OSA), group B (n = 68, TB-AIMH patients with OSA), and group C (n = 79, TBAD patients without OSA). Baseline characteristics, biochemical and sleep parameters, and STOP-Bang questionnaire scores were collected. To assess the predictive efficacy of potential variables, multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used. Results. The study found that about 58% of TBAD patients and 54% of TB-AIMH patients had OSA, a majority of whom had moderate to severe OSA (95.41% and 89.71%, respectively). In the comparison of sleep parameters between patients with TBAD and TB-AIMH, no other than apnea and hypopnea index (AHI) made a significant difference. The multivariate logistic regression analysis showed that neutrophil-to-lymphocyte ratio (NLR) (odds ratio (OR): 3.614, 95% confidence interval (CI): 2.273–5.748, and P < 0.05 ) and STOP-Bang scores (OR: 1.97, 95% CI: 1.34–2.90, and P < 0.05 ) were both independent predictors for OSA in patients with TBAD. ROC curves showed NLR had higher sensitivity (65% versus 59%) and specificity (86% versus 57%) for OSA than the STOP-Bang questionnaire. Furthermore, NLR was positively correlated with AHI through the Spearman test (r = 0.398 and P < 0.05 ). Conclusion. NLR was an independent predictor of OSA in TBAD patients with higher sensitivity and specificity than the STOP-Bang questionnaire, and it was positively associated with AHI. NLR may aid in the diagnosis and risk stratification of OSA in TBAD patients.

CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study

“…A previous report suggested that NLR could be used as a marker of chronic hypoxic burden in OSA, and therefore as a readily available parameter to evaluate CPAP effectiveness [ 77 ]. Furthermore, NLR was associated with cardiovascular comorbidities in OSA patients [ 79 , 80 ] and was an independent predictor of OSA in three other studies [ 54 , 81 , 82 ]. In a multi-center retrospective study (481 OSA cases and 80 controls) NLR was higher in patients with severe OSA, compared to controls and moderate and mild OSA [ 83 ], and a recent meta-analysis [ 84 ] concluded that neutrophilic inflammation plays a key role in OSA pathogenesis, suggesting that NLR could be viewed as a disease activity biomarker.…”