Abstract
Introduction Red cell distribution width (RDW) is a parameter included in the complete blood count which informs about the size of the circulating red blood cell population and its distribution. In adults, an increase in RDW was shown to be associated both with obstructive sleep apnoea (OSA) and with an increase in cardiovascular mortality. The aim of this study was to determine whether RDW is a potential biomarker for screening children with moderate–severe OSA.
Methods An observational study in snoring patients was performed. All patients underwent a sleep study and were classified either as simple snorers (apnoea–hypopnoea index (AHI) <1 event·h−1) or as patients with OSA (mild AHI ≥1 to <5 events·h−1; moderate–severe AHI ≥5 events·h−1). Blood analyses (complete blood count and C-reactive protein) were performed for every individual.
Results A total of 175 individuals were recruited. The mean age was 8.3±3.6 years. Correlation studies between RDW and several sleep-related parameters showed negative significant associations with minimum oxygen saturation, and positive significant associations with oxygen desaturation index (≥3% and ≥4%), AHI and the arousal index. A predictive model for paediatric severe OSA (AHI ≥5 events·h−1) was found based on mean corpuscular haemoglobin concentration (MCHC) <34.9 g·dL−1 and RDW >13.1% values, adjusting for body mass index z-score and age (area under the curve 0.657; p=0.004). In addition, differences were found in eosinophil count and C-reactive protein concentrations among the three subgroups.
Conclusions In children, RDW stands out as a biomarker associated with the severity of OSA. The use of RDW and MCHC could be a simple but useful tool for the severity prediction of paediatric OSA in snoring patients.
Abstract
Red cell distribution width and mean corpuscular haemoglobin concentration are blood markers associated with the severity of paediatric OSA https://bit.ly/2Asw1xa
Footnotes
Author contributions: N. Toledo-Pons, J.M. Sánchez, J. Peña-Zarza, A. Barceló, J.M. Bauça, D. Morell-Garcia and M. de la Peña-Bravo conceived and designed the study. N. Toledo-Pons, A. Barceló, D. Morell-Garcia, J. Peña-Zarza and P. Giménez supervised the data collection and managed the data, including quality control. N. Toledo-Pons, A. Barceló, D. Morell-Garcia and P. Sanchis provided statistical advice on study design and analysed the data, A. Barceló and M. de la Peña-Bravo chaired the data oversight committee. N. Toledo-Pons, A. Barceló, D. Morell-Garcia and J.M. Bauça drafted the manuscript, and all authors contributed substantially to its revision. D. Morell-Garcia, A. Barceló, N. Toledo-Pons and A. Alonso-Fernández take responsibility for the paper as a whole.
Conflict of interest: D. Morell-Garcia received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: N. Toledo-Pons received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: P. Sanchis received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: J.M. Bauça received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: J.M. Sánchez received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: J. Peña-Zarza received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: P. Giménez received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: J. Pierola received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: M. de la Peña-Bravo received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: A. Alonso-Fernández received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Conflict of interest: A. Barceló received a grant from Fondo de Investigación Sanitaria during the conduct of the study.
Support statement: This work was supported by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (grant FIS PI1302120). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received October 5, 2019.
- Accepted June 10, 2020.
- Copyright ©ERS 2020
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