Hematologic indices in pediatric sleep-disordered breathing: a retrospective case-control study

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI:10.1016/j.ijporl.2026.112755

Rita Teixeira Carvalho , Francisco Alves de Sousa , João Carvalho Almeida , Manuel Ferreira de Magalhães , Marta Rios , Miguel Bebiano Coutinho , Mariline Santos

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引用次数: 0

Abstract

Introduction

Pediatric obstructive sleep-disordered breathing (OSDB), commonly caused by adenotonsillar hypertrophy, ranges from primary snoring to obstructive sleep apnea syndrome (OSAS) and is a frequent reason for pediatric otolaryngology referral. OSDB leads to intermittent hypoxia, oxidative stress, systemic inflammation, and may activate the coagulation cascade, contributing to metabolic, cardiovascular, and neurocognitive complications. While these effects are more well-documented in adults, pediatric studies also report associations with obesity, insulin resistance, behavioral issues, and cognitive impairments. Diagnosis remains challenging due to the resource demands of polysomnography, prompting interest in alternative tools, including hematological biomarkers. In adults, markers like neutrophil-to-lymphocyte (N/L) and platelet-to-lymphocyte (P/L) ratios, as well as mean platelet volume (MPV), have shown promise; however, data in pediatric population are scarce.

Objectives

To compare hematological parameters in children with OSDB to those without OSDB.

Methods

We retrospectively analyzed data from children who were indicated for primary otorhinolaryngology surgery between January and May 2024. Pre-operative hematological data from children with OSDB (cases) were compared to those without OSDB (controls).

Results

166 patients (75 females, 91 males; mean age 5.4 ± 2.4 years; mean weight 22.3 ± 10.2 kg) were included. 85 children (51.2%) had OSDB. No significant differences were found between groups regarding age, sex, or weight (p > 0.05). Children with OSDB had significantly higher neutrophil-to-lymphocyte ratios (N/L ratio) (OSDB: 1.71 ± 1.02 vs. controls: 1.40 ± 0.67, p = 0.026) and platelet counts (OSDB: 328,152.94 ± 69,961.30 vs. controls: 302,876.54 ± 74,327.38, p = 0.025). No significant differences were encountered regarding neutrophil count (OSDB: 4260.59 ± 1755.87 vs controls: 3736.05 ± 1717.90, p = 0.054), total leukocyte count (OSDB: 8275.88 ± 1957.93, controls: 7624.57 ± 2351.98, p = 0.054) platelet-to-lymphocyte ratio (OSDB: 127.62 ± 49.50 vs controls: 114.17 ± 38.01, p = 0.052) and other hematological data, including coagulability state (p > 0.05 for prothrombin time, INR and APTT).

Conclusions

OSDB in children is associated with significantly increased N/L ratio and platelet count, suggesting a potential systemic inflammatory response. Further research is needed to determine the clinical significance of these findings.

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儿童睡眠呼吸障碍的血液学指标：一项回顾性病例对照研究

儿童阻塞性睡眠呼吸障碍（OSDB），通常由腺扁桃体肥大引起，范围从原发性打鼾到阻塞性睡眠呼吸暂停综合征（OSAS），是儿童耳鼻喉科转诊的常见原因。OSDB导致间歇性缺氧、氧化应激、全身性炎症，并可能激活凝血级联，导致代谢、心血管和神经认知并发症。虽然这些影响在成人中得到了更充分的证明，但儿科研究也报告了与肥胖、胰岛素抵抗、行为问题和认知障碍的关系。由于多导睡眠图的资源需求，诊断仍然具有挑战性，促使人们对包括血液学生物标志物在内的替代工具产生兴趣。在成人中，中性粒细胞对淋巴细胞（N/L）和血小板对淋巴细胞（P/L）比率以及平均血小板体积（MPV）等标志物已显示出希望；然而，儿科人群的数据很少。目的比较OSDB患儿与非OSDB患儿的血液学参数。方法回顾性分析2024年1月至5月间接受初级耳鼻喉外科手术的患儿资料。将有OSDB患儿（病例）的术前血液学数据与无OSDB患儿（对照组）进行比较。结果共纳入166例患者，其中女性75例，男性91例，平均年龄5.4±2.4岁，平均体重22.3±10.2 kg。85例（51.2%）患儿有OSDB。各组之间在年龄、性别或体重方面无显著差异（p > 0.05）。OSDB患儿中性粒细胞与淋巴细胞比值（N/L比值）（OSDB: 1.71±1.02，对照组：1.40±0.67,p = 0.026）和血小板计数（OSDB: 328,152.94±69,961.30，对照组：302,876.54±74,327.38,p = 0.025）显著升高。中性粒细胞计数（OSDB: 4260.59±1755.87 vs对照组：3736.05±1717.90,p = 0.054）、白细胞总数（OSDB: 8275.88±1957.93，对照组：7624.57±2351.98,p = 0.054）、血小板与淋巴细胞比值（OSDB: 127.62±49.50 vs对照组：114.17±38.01,p = 0.052）及其他血液学数据，包括凝血状态（凝血酶原时间、INR和APTT p >； 0.05）均无显著差异。结论儿童sosdb与N/L比值和血小板计数显著升高相关，提示可能存在全身性炎症反应。需要进一步的研究来确定这些发现的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.