Investigation of the relationship between mean platelet volume and obstructive sleep apnea syndrome

Objective: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent upper airway obstruction and intermittent hypoxia during sleep. Intermittent hypoxia and increased inflammatory activity plays a role in increased risk of cardiovascular disease in the OSAS. OSAS is an important cause of morbidity and mortality and cardiovascular disorders are the most important complications of OSAS. Mean platelet volume (MPV) is a marker of platelet activation and function, and increased platelet volume is associated with increased platelet activity. Different diseases related with inflammation, hypoxia, vascular injury, thrombosis and atherosclerosis were found to be associated with MPV. In this study, we aimed to investigate the relationship between OSAS and MPV. Methods: In this retrospective study, data of sex and age matched 33 patients with moderate OSAS, 34 patients with severe OSAS and 30 healthy subjects were evaluated. Results: The mean MPV was found in control, moderate OSAS and severe OSAS groups as 7.83±1.00, 8.26±1.40 and 8.94±1.20 (fL) respectively. The mean MPV value was significantly higher in severe OSAS group than control subjects (p=0.001). In correlation analysis, there were positive correlation between MPV with apnea-hypopnea index and total sleep time, and negative correlation between MPV with platelet count and minimum oxygen saturation (Respectively, p=0.003 / R=0.295, p=0.030 / R=0.221, p=0.011 / R= -0.257, p=0.019 / R= -0.238). Conclusion: In this study, the increased MPV was associated with severe OSAS and the results of this study suggest that the platelet activation is increased in OSAS. Hypoxia caused by OSAS, due to the activated platelets, may play a role in the development of cardiovascular diseases which is an important cause of morbidity and mortality in OSAS. J Clin Exp Invest 2013; 4 (4): 492-49

Assessment of mean platelet volume in chronic obstructive pulmonary disease during stable period and acute exacerbation

Objective: Chronic obstructive pulmonary disease (COPD) is an important public health problem and it is associated with systemic inflammation. Mean platelet volume (MPV) is one of the markers indicating platelet activation, and it was found to be high in many diseases related to inflammation. In previous studies reported different results evaluating of MPV in COPD. In this study, we aimed to evaluate of C-reactive protein (CRP), white blood cell (WBC), and MPV in acute exacerbation of COPD and stable COPD patients. Methods: In this retrospective study, data of 40 patients with acute exacerbation of COPD, 43 stable COPD patients and 40 healthy subjects were evaluated. Results: The mean MPV, CRP and WBC were found in control, stable COPD and acute exacerbation of COPD groups, 7.9±1.1; 8.2±1.3 and 8.7±1.6 fL; 3.4±1.2; 5.2±3.5 and 27.5±23.6 mg/L; 7.8±1.6; 8.1±2.1 and 11.4±4.5 x103/ ϻL, respectively. The mean WBC and CRP in the acute exacerbation of COPD group were significantly higher than the other groups (for both values p ˂0.001). The mean MPV in the acute exacerbation of COPD group was found higher than in the other groups. The mean MPV values were significantly higher in patients of acute exacerbation than control subjects (p=0.030). Conclusion: The results of this study suggest that the increased MPV may be a marker for the evaluation acute exacerbation of COPD as well as the classic acute phase reactant CRP. J Clin Exp Invest 2013; 4 (4): 483-48

Treatment Emergent Central Sleep Apnea: Should We Repeat Titration?

Most patients with Obstructive sleep apnea syndrome are treated with continuous positive airway pressure (CPAP). However, in some patients central apnea arises during CPAP titration. This clinical condition is defined as treatment-emergent central sleep apnea (CSA). Here, we would like to present a case who was diagnosed with treatment-emergent CSA during the first titration study, however CSA was lost in the second titration. Before the diagnosis of treatment-emergent CSA, factors of titration should be reviewed and if it is not found satisfactory, procedure should be repeated. In most cases CPAP therapy eliminates CSA. However, in some cases bilevel positive airway pressure- spontaneous/timed or adaptive servo ventilator is needed. Repeated titration could be useful tool to predict whether the patient needs CPAP or advanced therapies