Obstructive sleep apnea syndrome and thromboembolism relationship

Objective: Our aim in this study is to look at Complete Blood Count (CBC), ComprehensiveMetabolicPanel (CMP), Arterial Blood Gas, Sedimentation, PT, APTT, C-reactive protein (CRP), Fibrinogen, D-dimer, Thrombophilia panel, Homocysteine, in patients diagnosed with OSA; to show whether OSA has an effect on the tendency to thrombosis with the obtained data and to contribute positively to the planning for the treatment and follow-up of these patients Method: Sleep tests were performed with a polysomnography device in a sleep laboratory environment at Harran University Faculty of Medicine Chest Diseases Clinic between September 2022 and June 2023 for patients who applied with a preliminary diagnosis of obstructive sleep apnea. The patient's blood was taken simultaneously. Patients diagnosed with OSA were classifiedinto 4 groups, normal, light, moderate, and severe, according to the polysomnography device data. According to the blood results obtained from these groups, the changes in laboratory parameters in terms of thrombo-embolism and the correlation levels of blood between the groups were examined. SPSS 22.0 program was used for statistical analyses, using appropriate statistical analyses, and the p-value< 0.05 as the significance level. Findings: A total of 91 participants, 34 (37.4%) women, and 57 (62.6%) men, were included in the study. 35.2% of the participants (n=32)had Hypertension (HTN), in 22.0% (n=20) coronary artery disease (CAD), in 26.4% (n=24) diabetes mellitus (DM), in 50.5% (n=46) hyperlipidemia and in 5.5% of (n=5) it has been found that there is a cerebrovascular disease. 63.7% of the participants (n=58) high level of snoring, 6.6% (n=6) moderate snoring, and 28.6% (n=26) on the other hand, it has been found that there is a slight level of snoring. It was found that there were positive significant relationships between AHI and ODI scores and blood CRP (rho= 0.27 and p<0.05), Fibrinogen (rho=0.25 and p<0.05) and % (PT) (rho=0.22 and p<0.05) values. It has been found that there is a significant negative relationship between REM sleep duration and Fibrinogen values in the blood (rho= -0.23 and p<0.05). There are positive significant differences between the MTHFR C677T gene mutant group ODI scores and blood CRP and D-Dimer values (rho=0.37 and p<0.05; rho=0.35 and p<0.05). It was found that there were positive significant relationships between ODI scores of the IX PAI-1 4G/5G gene mutant group and CRP, Fibrinogen, and % (PT) values in the blood (rho=0.34 and p<0.05; rho=0.32 and p<0.05; rho=0.31 and p<0.05).The MTHFR C677T gene mutant group has a positive and significant relationship between total sleep time and blood CRP values (rho=0.35 and p<0.05).It was found that there was a negative significant relationship between the AHI scores of the PAI-1 4G/5G gene mutant group and the INR values in the blood (rho=-0.31 and p<0.05It was found that there was a significant positive relationship between the AHI and ODI scores of the Factor XIII V35L gene mutant group and the Homocysteine values in the blood (rho=0.62 and p<0.05).It was found that there was a significant negative relationship between ODI scores and blood INR values of the PAI-1 4G/5G gene mutant group (rho=-0.32 and p<0.05). Results: The patients who participated in our study showed parallels with the literature in terms of demographic and polysomnographic characteristics. In our study, it was found that there are positive significant relationships between AHI and ODI scores and CRP, Fibrinogen, D-dimer, and %(PT) values in the blood. This situation suggests that there is a significant relationship between OSAS and thromboembolism. CRP and D dimer that we have analyzed acts by proinflammatory mechanisms in many situations, especially during REM sleep. It was determined that MTHFR C677T and PAI-1 4G/5G mutations were more effective on sleep parameters compared to Factor XIII V35L mutation. Genome sequencing and other genetic analyses are needed to understand the connection between sleep apnea variables and venous thromboembolic events. It is thought that with more research studies, the literature will improve in terms of elucidation of the basic mechanisms involved in the pathogenesis of the disease, progression, the level of impact of related diseases, and symptomatic differential diagnosis. Key words: Obstructive Sleep apnea, Thromboembolism, REM sleep, Snoring, Apnea-Hypopnea index