Antonia Barceló1, Daniel Morell-Garcia2, Pilar Sanchís3, José Antonio Peña-Zarza4, Josep Miquel Bauça5, Javier Piérola3, Mónica de la Peña6, Nuria Toledo-Pons7, Paloma Giménez3, Caterina Ribot3, Alberto Alonso-Fernández6. 1. Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain; CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain. 2. Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain. Electronic address: daniel.morell@ssib.es. 3. Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain. 4. Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain; Sleep Unit, Department of Pediatrics, Hospital Universitari Son Espases, Palma de Mallorca, Spain. 5. Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain. 6. Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain; CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain; Department of Respiratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain. 7. Institut d'Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain; Department of Respiratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
Abstract
OBJECTIVE: Increased blood coagulation might be one important mechanism linking obstructive sleep apnea (OSA) with cardiovascular diseases. We tested the association between several hemostatic parameters and sleep breathing-related variables in a representative pediatric population with a clinical suspicion of OSA. METHODS: Polysomnography was performed in 152 snoring children to diagnose OSA. Anthropometric and clinical data were registered and venous blood samples were collected for the measurement of platelet count, plateletcrit, platelet distribution width (PDW), mean platelet volume (MPV), prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and C-reactive protein. RESULTS: Children with OSA had significantly higher platelet count, plateletcrit and PDW compared with those without OSA. After controlling for the anthropometric characteristics (age, gender, body mass index (BMI) z-score), platelet count negatively correlated with minimum SaO2 while the plateletcrit correlated with time with SaO2 <90% and MPV correlated with apnea-hypopnea index. PT and PT international normalized ratio correlated with mean SaO2 and aPTT correlated with the oxygen desaturation index. CONCLUSION: Our findings suggest that different OSA-related effects may be factors contributing to an enhanced coagulability in pediatric OSA. Measures reflecting apnea severity and disrupted sleep were associated with clotting factor changes independent of covariates affecting hemostatic function.
OBJECTIVE: Increased blood coagulation might be one important mechanism linking obstructive sleep apnea (OSA) with cardiovascular diseases. We tested the association between several hemostatic parameters and sleep breathing-related variables in a representative pediatric population with a clinical suspicion of OSA. METHODS: Polysomnography was performed in 152 snoring children to diagnose OSA. Anthropometric and clinical data were registered and venous blood samples were collected for the measurement of platelet count, plateletcrit, platelet distribution width (PDW), mean platelet volume (MPV), prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and C-reactive protein. RESULTS:Children with OSA had significantly higher platelet count, plateletcrit and PDW compared with those without OSA. After controlling for the anthropometric characteristics (age, gender, body mass index (BMI) z-score), platelet count negatively correlated with minimum SaO2 while the plateletcrit correlated with time with SaO2 <90% and MPV correlated with apnea-hypopnea index. PT and PT international normalized ratio correlated with mean SaO2 and aPTT correlated with the oxygen desaturation index. CONCLUSION: Our findings suggest that different OSA-related effects may be factors contributing to an enhanced coagulability in pediatric OSA. Measures reflecting apnea severity and disrupted sleep were associated with clotting factor changes independent of covariates affecting hemostatic function.
Authors: Aditya A Joshi; Raef H Hajjali; Avantee V Gokhale; Triston Smith; Amit K Dey; Garima Dahiya; Joseph B Lerman; Aparna P Sajja; Manreet Kanwar; Amresh Raina Journal: Pulm Circ Date: 2021-03-27 Impact factor: 3.017