Taomei Li1, Naima Covassin2, Lu Tan1, Rong Ren1, Ye Zhang1, Fei Lei1, Linghui Yang1, Junying Zhou1, Hongqiang Sun3, Virend K Somers2, Xiangdong Tang1. 1. Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Translational Neuroscience Center, State Key Laboratory, West China Hospital, Sichuan University, Chengdu, China. 2. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. 3. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
Abstract
STUDY OBJECTIVES: Hypoxemic effects of obstructive sleep apnea (OSA) have been implicated in changes in erythropoiesis and hence erythrocyte measures. Sex differences are evident in both OSA and erythropoiesis. Whether sex modulates the relationship between severity of OSA and erythrocyte measures has not previously been studied. METHODS: We examined a sample of 976 patients (38% women) who underwent overnight polysomnography and measurement of red blood cell count, hemoglobin, and hematocrit. Patients were divided into primary snoring and mild, moderate, and severe OSA groups, separately by sex. RESULTS: In multiple regression models, we found significant interactions between sex and oxygen desaturation index and apnea-hypopnea index on erythrocyte measures. Higher oxygen desaturation index and higher apnea-hypopnea index were independently associated with higher red blood cell count, hemoglobin, and hematocrit in women but not in men. Further ordinal logistic regression analysis showed a significant association between oxygen desaturation index (odds ratio, 2.33; 95% confidence interval, 1.17-4.66) and apnea-hypopnea index (odds ratio, 2.44; 95% confidence interval, 1.23-4.84) and red blood cell count in women only. Correlation analysis also showed that erythrocyte measures and markers of cardiometabolic risk were more closely correlated in women than in men. CONCLUSIONS: This study provides novel data suggesting a significant association between erythrocyte measures and OSA severity in women but not in men. Similarly, the relationship between hematologic metrics and cardiometabolic risk markers was more pronounced in women than in men. Our findings suggest a sex-specific impact of OSA on erythrocyte measures and on their relationship with indexes of cardiometabolic risk.
STUDY OBJECTIVES: Hypoxemic effects of obstructive sleep apnea (OSA) have been implicated in changes in erythropoiesis and hence erythrocyte measures. Sex differences are evident in both OSA and erythropoiesis. Whether sex modulates the relationship between severity of OSA and erythrocyte measures has not previously been studied. METHODS: We examined a sample of 976 patients (38% women) who underwent overnight polysomnography and measurement of red blood cell count, hemoglobin, and hematocrit. Patients were divided into primary snoring and mild, moderate, and severe OSA groups, separately by sex. RESULTS: In multiple regression models, we found significant interactions between sex and oxygen desaturation index and apnea-hypopnea index on erythrocyte measures. Higher oxygen desaturation index and higher apnea-hypopnea index were independently associated with higher red blood cell count, hemoglobin, and hematocrit in women but not in men. Further ordinal logistic regression analysis showed a significant association between oxygen desaturation index (odds ratio, 2.33; 95% confidence interval, 1.17-4.66) and apnea-hypopnea index (odds ratio, 2.44; 95% confidence interval, 1.23-4.84) and red blood cell count in women only. Correlation analysis also showed that erythrocyte measures and markers of cardiometabolic risk were more closely correlated in women than in men. CONCLUSIONS: This study provides novel data suggesting a significant association between erythrocyte measures and OSA severity in women but not in men. Similarly, the relationship between hematologic metrics and cardiometabolic risk markers was more pronounced in women than in men. Our findings suggest a sex-specific impact of OSA on erythrocyte measures and on their relationship with indexes of cardiometabolic risk.
Authors: Daniel J Gottlieb; Gayane Yenokyan; Anne B Newman; George T O'Connor; Naresh M Punjabi; Stuart F Quan; Susan Redline; Helaine E Resnick; Elisa K Tong; Marie Diener-West; Eyal Shahar Journal: Circulation Date: 2010-07-12 Impact factor: 29.690
Authors: Siobán D Harlow; Margery Gass; Janet E Hall; Roger Lobo; Pauline Maki; Robert W Rebar; Sherry Sherman; Patrick M Sluss; Tobie J de Villiers Journal: Menopause Date: 2012-04 Impact factor: 2.953
Authors: E Vagiakis; F Kapsimalis; I Lagogianni; H Perraki; A Minaritzoglou; K Alexandropoulou; C Roussos; M Kryger Journal: Sleep Med Date: 2006-06-05 Impact factor: 3.492
Authors: Cynthia K Sites; Michael J Toth; Mary Cushman; Georgia D L'Hommedieu; André Tchernof; Russell P Tracy; Eric T Poehlman Journal: Fertil Steril Date: 2002-01 Impact factor: 7.329