OSA complication score as novel reference to assess systemic inflammation in sleep apnoea

Breathing disorders during sleep increase the risk of many serious complications and pathophysiological abnormalities. The obstructive sleep apnoea syndrome (OSAS) and related comorbidities are accompanied by systemic inflammation. In our conducting study on immune response in OSAS we observed significant changes related to comorbidities. Thus we constructed our own OSA complications score (OCS) . The aim of our study was to assess the usefulness of this score in evaluation of character and severity of inflammation. OCS was calculated for 50 OSA patients by adding up the following factors: obesity, diabetes, hypertension, ischemic heart disease, stroke and current smoking history (there were OCS grades from 0 to 6). The systemic immune response was investigated by the analysis of peripheral blood lymphocyte subpopulations by flow cytometry and by measurement of IL-1β, TNF-α and adiponectin concentration (ELISA). We found significant positive relation between the OCS score and apnoea/hypopnea index (AHI), white blood cells number, concentration of CRP, fibrinogen, the number of T cells and HLA DR+ T cells and a negative relation with peripheral oxygen saturation (SpO 2 min), adiponectin concentration (p 0.3 in Spearman test). The high OCS grade was associated with high number of CD8+, NK, NKT cells, TNFα concentration and a low proportion of B cells (correlation not significant). We concluded that the newly developed OCS was proved useful for the assessment of OSA-induced immune alterations and can be useful quantitative tool in further OSAS studies.