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KMID : 1101120180150010020
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Journal of Sleep Medicine
2018 Volume.15 No. 1 p.20 ~ p.26
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Hematologic Markers as a Predictive Factor for Moderate to Severe Obstructive Sleep Apnea Syndrome in Children and Adolescents
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Kim Seung-Soo
Yang Kwang-Ik
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Abstract
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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.
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KEYWORD
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Children, Sleep apnea syndrome, Red cell distribution width, Platelet distribution width
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