Aditi Shah, Mohammadreza Hajipour, A J Hirsch Allen, Najib Ayas, Tetyana Kendzerska, Patrick Hanly, John Kimoff, Frederic Series, Annie Lajoie, Rebecca Robillard, Rachel Jen, Andrew E Beaudin, Jill Raneri, Robert Skomro
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The percentage of time spent below SpO<sub>2</sub> <90% (T90) and minimum SpO<sub>2</sub> we considered as other measures of nocturnal hypoxemia. Multiple linear regressions were used to assess associations between total white blood cell (WBC) and subsets and ODI and hypoxemia indices.</p><p><strong>Results: </strong>A total of 1296 patients were included in the analysis. There was a positive association between ODI4% and lymphocyte count, adjusting for confounders. For every 1-<i>SD</i> increase in ODI4%, lymphocyte counts increased by 0.08 × 10<sup>9</sup> L (95% CI 0.01 to 0.15) <i>SD</i>. Patients with severe OSA (ODI4% ≥ 30 events/hour) had significantly higher total WBC and lymphocyte count than non-OSA cohort, in the adjusted model, <i>p</i>-value <.02, for both. There was a positive association between T90 and total WBC, neutrophil, lymphocyte, and monocyte count, adjusting for confounders. Minimum SpO<sub>2</sub> was independently associated with total WBC, neutrophil, and monocyte counts.</p><p><strong>Conclusions: </strong>In this pan-Canadian clinic-based cohort of individuals with suspected OSA, nocturnal hypoxemia indices were associated with an increase in total WBC and subset counts.</p>","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":"6 2","pages":"zpaf028"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198955/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of nocturnal hypoxemia and white blood cell count in a multicenter cohort.\",\"authors\":\"Aditi Shah, Mohammadreza Hajipour, A J Hirsch Allen, Najib Ayas, Tetyana Kendzerska, Patrick Hanly, John Kimoff, Frederic Series, Annie Lajoie, Rebecca Robillard, Rachel Jen, Andrew E Beaudin, Jill Raneri, Robert Skomro\",\"doi\":\"10.1093/sleepadvances/zpaf028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study objectives: </strong>There is a higher risk of cardiovascular disease (CVD) in patients with obstructive sleep apnea (OSA) and innate immunity is a potential pathophysiologic pathway. The objective of this study was to determine whether nocturnal hypoxemia is associated with circulating markers of innate immunity in OSA.</p><p><strong>Methods: </strong>This was a cross-sectional study of an observational cohort from the multicentre, clinic-based, Canadian Sleep and Circadian Network. Oxygen desaturation index 4% (ODI4%) was used to diagnose and determine the severity of OSA. The percentage of time spent below SpO<sub>2</sub> <90% (T90) and minimum SpO<sub>2</sub> we considered as other measures of nocturnal hypoxemia. Multiple linear regressions were used to assess associations between total white blood cell (WBC) and subsets and ODI and hypoxemia indices.</p><p><strong>Results: </strong>A total of 1296 patients were included in the analysis. There was a positive association between ODI4% and lymphocyte count, adjusting for confounders. For every 1-<i>SD</i> increase in ODI4%, lymphocyte counts increased by 0.08 × 10<sup>9</sup> L (95% CI 0.01 to 0.15) <i>SD</i>. Patients with severe OSA (ODI4% ≥ 30 events/hour) had significantly higher total WBC and lymphocyte count than non-OSA cohort, in the adjusted model, <i>p</i>-value <.02, for both. There was a positive association between T90 and total WBC, neutrophil, lymphocyte, and monocyte count, adjusting for confounders. 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引用次数: 0
摘要
研究目的:阻塞性睡眠呼吸暂停(OSA)患者发生心血管疾病(CVD)的风险较高,先天免疫是一种潜在的病理生理途径。本研究的目的是确定夜间低氧血症是否与OSA患者先天免疫的循环标志物有关。方法:这是一项来自多中心、临床为基础的加拿大睡眠和昼夜节律网络的观察性队列的横断面研究。氧去饱和指数4% (ODI4%)用于诊断和判断OSA的严重程度。我们认为低于SpO2的时间百分比是夜间低氧血症的其他指标。使用多元线性回归来评估总白细胞(WBC)和亚群与ODI和低氧血症指数之间的关系。结果:共纳入1296例患者。经混杂因素调整后,ODI4%与淋巴细胞计数呈正相关。ODI4%每增加1-SD,淋巴细胞计数增加0.08 × 109 L (95% CI 0.01 ~ 0.15) SD。重度OSA患者(ODI4%≥30事件/小时)的总白细胞计数和淋巴细胞计数明显高于非OSA队列,在调整后的模型中,p值2与总白细胞计数、中性粒细胞计数和单核细胞计数独立相关。结论:在这个泛加拿大临床为基础的疑似OSA患者队列中,夜间低氧血症指数与白细胞总数和亚群计数的增加有关。
Association of nocturnal hypoxemia and white blood cell count in a multicenter cohort.
Study objectives: There is a higher risk of cardiovascular disease (CVD) in patients with obstructive sleep apnea (OSA) and innate immunity is a potential pathophysiologic pathway. The objective of this study was to determine whether nocturnal hypoxemia is associated with circulating markers of innate immunity in OSA.
Methods: This was a cross-sectional study of an observational cohort from the multicentre, clinic-based, Canadian Sleep and Circadian Network. Oxygen desaturation index 4% (ODI4%) was used to diagnose and determine the severity of OSA. The percentage of time spent below SpO2 <90% (T90) and minimum SpO2 we considered as other measures of nocturnal hypoxemia. Multiple linear regressions were used to assess associations between total white blood cell (WBC) and subsets and ODI and hypoxemia indices.
Results: A total of 1296 patients were included in the analysis. There was a positive association between ODI4% and lymphocyte count, adjusting for confounders. For every 1-SD increase in ODI4%, lymphocyte counts increased by 0.08 × 109 L (95% CI 0.01 to 0.15) SD. Patients with severe OSA (ODI4% ≥ 30 events/hour) had significantly higher total WBC and lymphocyte count than non-OSA cohort, in the adjusted model, p-value <.02, for both. There was a positive association between T90 and total WBC, neutrophil, lymphocyte, and monocyte count, adjusting for confounders. Minimum SpO2 was independently associated with total WBC, neutrophil, and monocyte counts.
Conclusions: In this pan-Canadian clinic-based cohort of individuals with suspected OSA, nocturnal hypoxemia indices were associated with an increase in total WBC and subset counts.