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Erschienen in: Sleep and Breathing 2/2022

22.07.2021 | Pediatrics • Original Article

Changes in platelet count and coagulation parameters in children with obstructive sleep apnea

verfasst von: Tian Shen, Jing Wang, Linke Li, Yixin Qiao, Xiaohong Yan, Min Chen, Xiangdong Tang, Jian Zou, Yu Zhao

Erschienen in: Sleep and Breathing | Ausgabe 2/2022

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Abstract

Objective

To investigate the correlation between obstructive sleep apnea (OSA) and coagulation status and to speculate on the underlying mechanism in children with OSA.

Methods

We divided 345 children with OSA (age 2–14 years) into four groups according to the apnea–hypopnea index (AHI). We compared platelet (PLT) and coagulation parameters among groups. Correlations between the polysomnography parameters and coagulation parameters were investigated.

Results

Children with OSA had higher PLT counts than those without OSA (P < 0.001), while no significant difference was observed in prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time, or fibrinogen among children with/without OSA. In linear regression analysis, the AHI and oxygen desaturation index (ODI) presented positive correlation with the PLT count (R2 = 0.155, beta = 0.307, P < 0.001 and R2 = 0.113, beta = 0.262, P < 0.001), and there was no correlation among the AHI, ODI, and other coagulation parameters. The minimum and mean oxygen saturation of arterial blood manifested negative correlation with the PLT count (R2 = 0.076, beta =  − 0.116, P = 0.034 and R2 = 0.083, beta =  − 0.140, P = 0.008, respectively).

Conclusions

Children with OSA have a higher PLT count, positively correlated with OSA severity, and no evidence of coagulation disorder.
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Literatur
1.
Zurück zum Zitat Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053CrossRef Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053CrossRef
2.
Zurück zum Zitat Smith DF, Amin RS (2019) OSA and cardiovascular risk in pediatrics. Chest 156(2):402–413CrossRef Smith DF, Amin RS (2019) OSA and cardiovascular risk in pediatrics. Chest 156(2):402–413CrossRef
3.
Zurück zum Zitat Almendros I, Carreras A, Ramírez J, Montserrat JM, Navajas D, Farré R (2008) Upper airway collapse and reopening induce inflammation in a sleep apnoea model. Eur Respir J 32(2):399–404CrossRef Almendros I, Carreras A, Ramírez J, Montserrat JM, Navajas D, Farré R (2008) Upper airway collapse and reopening induce inflammation in a sleep apnoea model. Eur Respir J 32(2):399–404CrossRef
4.
Zurück zum Zitat Amin RS, Kimball TR, Bean JA et al (2002) Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 165(10):1395–1399CrossRef Amin RS, Kimball TR, Bean JA et al (2002) Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 165(10):1395–1399CrossRef
5.
Zurück zum Zitat Sánchez-de-la-Torre M, Campos-Rodriguez F, Barbé F (2013) Obstructive sleep apnoea and cardiovascular disease. Lancet Respir Med 1(1):61–72CrossRef Sánchez-de-la-Torre M, Campos-Rodriguez F, Barbé F (2013) Obstructive sleep apnoea and cardiovascular disease. Lancet Respir Med 1(1):61–72CrossRef
6.
Zurück zum Zitat Al Lawati NM, Ayas NT (2008) Hypercoagulability: another potential mechanism of obstructive sleep apnea-related cardiovascular disease. Lung 186(4):195–196CrossRef Al Lawati NM, Ayas NT (2008) Hypercoagulability: another potential mechanism of obstructive sleep apnea-related cardiovascular disease. Lung 186(4):195–196CrossRef
7.
Zurück zum Zitat Barceló A, Morell-Garcia D, Sanchís P et al (2019) Prothrombotic state in children with obstructive sleep apnea. Sleep Med 53:101–105CrossRef Barceló A, Morell-Garcia D, Sanchís P et al (2019) Prothrombotic state in children with obstructive sleep apnea. Sleep Med 53:101–105CrossRef
8.
Zurück zum Zitat Zicari AM, Occasi F, Di Mauro F et al (2016) Mean platelet volume, vitamin D and C reactive protein levels in normal weight children with primary snoring and obstructive sleep apnea syndrome. PLoS One 11(4):e0152497CrossRef Zicari AM, Occasi F, Di Mauro F et al (2016) Mean platelet volume, vitamin D and C reactive protein levels in normal weight children with primary snoring and obstructive sleep apnea syndrome. PLoS One 11(4):e0152497CrossRef
9.
Zurück zum Zitat Gabryelska A, Łukasik ZM, Makowska JS, Białasiewicz P (2018) Obstructive sleep apnea: from intermittent hypoxia to cardiovascular complications via blood platelets. Front Neurol 9:635CrossRef Gabryelska A, Łukasik ZM, Makowska JS, Białasiewicz P (2018) Obstructive sleep apnea: from intermittent hypoxia to cardiovascular complications via blood platelets. Front Neurol 9:635CrossRef
10.
11.
Zurück zum Zitat Wessendorf TE, Thilmann AF, Wang YM, Schreiber A, Konietzko N, Teschler H (2000) Fibrinogen levels and obstructive sleep apnea in ischemic stroke. Am J Respir Crit Care Med 162(6):2039–2042CrossRef Wessendorf TE, Thilmann AF, Wang YM, Schreiber A, Konietzko N, Teschler H (2000) Fibrinogen levels and obstructive sleep apnea in ischemic stroke. Am J Respir Crit Care Med 162(6):2039–2042CrossRef
12.
Zurück zum Zitat Zhan X, Li L, Wang N et al (2016) Can upper airway surgery for OSA protect against cardiovascular sequelae via effects on coagulation. Acta Otolaryngol 136(3):293–297CrossRef Zhan X, Li L, Wang N et al (2016) Can upper airway surgery for OSA protect against cardiovascular sequelae via effects on coagulation. Acta Otolaryngol 136(3):293–297CrossRef
13.
Zurück zum Zitat Corso RM, Gregoretti C, Braghiroli A, Fanfulla F, Insalaco G (2014) Practice guidelines for the perioperative management of patients with obstructive sleep apnea: navigating through uncertainty. Anesthesiology 121(3):664–665CrossRef Corso RM, Gregoretti C, Braghiroli A, Fanfulla F, Insalaco G (2014) Practice guidelines for the perioperative management of patients with obstructive sleep apnea: navigating through uncertainty. Anesthesiology 121(3):664–665CrossRef
14.
Zurück zum Zitat Berry RB, Budhiraja R, Gottlieb DJ et al (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8(5):597–619CrossRef Berry RB, Budhiraja R, Gottlieb DJ et al (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8(5):597–619CrossRef
15.
Zurück zum Zitat Saygin M, Ozturk O, Ozguner MF, Akkaya A, Varol E (2016) Hematological parameters as predictors of cardiovascular disease in obstructive sleep apnea syndrome patients. Angiology 67(5):461–470CrossRef Saygin M, Ozturk O, Ozguner MF, Akkaya A, Varol E (2016) Hematological parameters as predictors of cardiovascular disease in obstructive sleep apnea syndrome patients. Angiology 67(5):461–470CrossRef
16.
Zurück zum Zitat Qiu Y, Li X, Zhang X et al (2020) Prothrombotic factors in obstructive sleep apnea: a systematic review with meta-analysis. Ear Nose Throat J 11:0145561320965208 Qiu Y, Li X, Zhang X et al (2020) Prothrombotic factors in obstructive sleep apnea: a systematic review with meta-analysis. Ear Nose Throat J 11:0145561320965208
17.
Zurück zum Zitat García Suquia A, Alonso-Fernández A, de la Peña M et al (2015) High D-dimer levels after stopping anticoagulants in pulmonary embolism with sleep apnoea. Eur Respir J 46(6):1691–1700CrossRef García Suquia A, Alonso-Fernández A, de la Peña M et al (2015) High D-dimer levels after stopping anticoagulants in pulmonary embolism with sleep apnoea. Eur Respir J 46(6):1691–1700CrossRef
18.
Zurück zum Zitat Barceló A, Piérola J, de la Peña M et al (2012) Impaired circadian variation of platelet activity in patients with sleep apnea. Sleep Breath 16(2):355–360CrossRef Barceló A, Piérola J, de la Peña M et al (2012) Impaired circadian variation of platelet activity in patients with sleep apnea. Sleep Breath 16(2):355–360CrossRef
19.
Zurück zum Zitat Ae R, Abrams JY, Maddox RA et al (2020) Platelet count variation and risk for coronary artery abnormalities in Kawasaki disease. Pediatr Infect Dis J 39(3):197–203CrossRef Ae R, Abrams JY, Maddox RA et al (2020) Platelet count variation and risk for coronary artery abnormalities in Kawasaki disease. Pediatr Infect Dis J 39(3):197–203CrossRef
20.
Zurück zum Zitat Giona F, Teofili L, Moleti ML et al (2012) Thrombocythemia and polycythemia in patients younger than 20 years at diagnosis: clinical and biologic features, treatment, and long-term outcome. Blood 119(10):2219–2227CrossRef Giona F, Teofili L, Moleti ML et al (2012) Thrombocythemia and polycythemia in patients younger than 20 years at diagnosis: clinical and biologic features, treatment, and long-term outcome. Blood 119(10):2219–2227CrossRef
21.
Zurück zum Zitat Somers VK, White DP, Amin R et al (2008) Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 118(10):1080–111CrossRef Somers VK, White DP, Amin R et al (2008) Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation 118(10):1080–111CrossRef
22.
Zurück zum Zitat Sert Kuniyoshi FH, Singh P, Gami AS et al (2011) Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction. Chest 140(1):62–67CrossRef Sert Kuniyoshi FH, Singh P, Gami AS et al (2011) Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction. Chest 140(1):62–67CrossRef
23.
Zurück zum Zitat Xie J, SertKuniyoshi FH, Covassin N et al (2016) Nocturnal hypoxemia due to obstructive sleep apnea is an independent predictor of poor prognosis after myocardial infarction. J Am Heart Assoc 5(8):e003162 Xie J, SertKuniyoshi FH, Covassin N et al (2016) Nocturnal hypoxemia due to obstructive sleep apnea is an independent predictor of poor prognosis after myocardial infarction. J Am Heart Assoc 5(8):e003162
24.
Zurück zum Zitat Kucine N, Chastain KM, Mahler MB, Bussel JB (2014) Primary thrombocytosis in children. Haematologica 99(4):620–628CrossRef Kucine N, Chastain KM, Mahler MB, Bussel JB (2014) Primary thrombocytosis in children. Haematologica 99(4):620–628CrossRef
25.
Zurück zum Zitat Winnicki M, Shamsuzzaman A, Lanfranchi P et al (2004) Erythropoietin and obstructive sleep apnea. Am J Hypertens 17(9):783–786CrossRef Winnicki M, Shamsuzzaman A, Lanfranchi P et al (2004) Erythropoietin and obstructive sleep apnea. Am J Hypertens 17(9):783–786CrossRef
26.
Zurück zum Zitat Stohlawetz PJ, Dzirlo L, Hergovich N et al (2000) Effects of erythropoietin on platelet reactivity and thrombopoiesis in humans. Blood 95(9):2983–2989CrossRef Stohlawetz PJ, Dzirlo L, Hergovich N et al (2000) Effects of erythropoietin on platelet reactivity and thrombopoiesis in humans. Blood 95(9):2983–2989CrossRef
27.
Zurück zum Zitat Wolf RF, Peng J, Friese P, Gilmore LS, Burstein SA, Dale GL (1997) Erythropoietin administration increases production and reactivity of platelets in dogs. Thromb Haemost 78(6):1505–1509CrossRef Wolf RF, Peng J, Friese P, Gilmore LS, Burstein SA, Dale GL (1997) Erythropoietin administration increases production and reactivity of platelets in dogs. Thromb Haemost 78(6):1505–1509CrossRef
28.
Zurück zum Zitat Sharpe PC, Desai ZR, Morris TC (1994) Increase in mean platelet volume in patients with chronic renal failure treated with erythropoietin. J Clin Pathol 47(2):159–161CrossRef Sharpe PC, Desai ZR, Morris TC (1994) Increase in mean platelet volume in patients with chronic renal failure treated with erythropoietin. J Clin Pathol 47(2):159–161CrossRef
29.
Zurück zum Zitat Mackman N, Tilley RE, Key NS (2007) Role of the extrinsic pathway of blood coagulation in hemostasis and thrombosis. Arterioscler Thromb Vasc Biol 27(8):1687–1693CrossRef Mackman N, Tilley RE, Key NS (2007) Role of the extrinsic pathway of blood coagulation in hemostasis and thrombosis. Arterioscler Thromb Vasc Biol 27(8):1687–1693CrossRef
30.
Zurück zum Zitat Hong SN, Yun HC, Yoo JH, Lee SH (2017) Association between hypercoagulability and severe obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg 143(10):996–1002CrossRef Hong SN, Yun HC, Yoo JH, Lee SH (2017) Association between hypercoagulability and severe obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg 143(10):996–1002CrossRef
31.
Zurück zum Zitat Budhiraja R, Parthasarathy S, Quan SF (2007) Endothelial dysfunction in obstructive sleep apnea. J Clin Sleep Med 3(4):409–415CrossRef Budhiraja R, Parthasarathy S, Quan SF (2007) Endothelial dysfunction in obstructive sleep apnea. J Clin Sleep Med 3(4):409–415CrossRef
32.
Zurück zum Zitat Shamsuzzaman A, Amin RS, Calvin AD, Davison D, Somers VK (2014) Severity of obstructive sleep apnea is associated with elevated plasma fibrinogen in otherwise healthy patients. Sleep Breath 18(4):761–766CrossRef Shamsuzzaman A, Amin RS, Calvin AD, Davison D, Somers VK (2014) Severity of obstructive sleep apnea is associated with elevated plasma fibrinogen in otherwise healthy patients. Sleep Breath 18(4):761–766CrossRef
33.
Zurück zum Zitat Toraldo DM, Peverini F, De Benedetto M, De Nuccio F (2013) Obstructive sleep apnea syndrome: blood viscosity, blood coagulation abnormalities, and early atherosclerosis. Lung 191(1):1–7CrossRef Toraldo DM, Peverini F, De Benedetto M, De Nuccio F (2013) Obstructive sleep apnea syndrome: blood viscosity, blood coagulation abnormalities, and early atherosclerosis. Lung 191(1):1–7CrossRef
Metadaten
Titel
Changes in platelet count and coagulation parameters in children with obstructive sleep apnea
verfasst von
Tian Shen
Jing Wang
Linke Li
Yixin Qiao
Xiaohong Yan
Min Chen
Xiangdong Tang
Jian Zou
Yu Zhao
Publikationsdatum
22.07.2021
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 2/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-021-02443-8

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