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Updated: Mar 1, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Blood count values and ratios for predicting sleep apnea in obese children
Ibrahim Erdim1, Omer Erdur2, Fatih Oghan3
1Department of Otolaryngology, Erbaa Government Hospital, Tokat, Turkey.
Insights
Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) may help diagnose sleep apnea in obese children. Mean platelet volume (MPV) did not show a correlation with the condition.
Area of Science:
- Pediatric Sleep Medicine
- Hematology
- Obesity Research
Background:
- Obesity is a growing public health concern with increasing prevalence.
- Polysomnography (PSG) is the standard for diagnosing sleep apnea but is resource-intensive.
- There is a need for simpler diagnostic methods for sleep apnea in obese children.
Purpose of the Study:
- To investigate if mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are associated with the diagnosis and severity of Obstructive Sleep Apnea (OSAS) in obese children.
- To explore the potential of these complete blood count (CBC) parameters as accessible biomarkers for OSAS.
Main Methods:
- Retrospective analysis of clinical records from 180 patients.
- Blood samples were analyzed for various parameters including MPV, NLR, and PLR.
- 127 obese children underwent polysomnography (PSG) and were categorized into non-OSAS (AHI < 1), mild-to-moderate OSAS (1 ≤ AHI < 5), and severe OSAS (AHI ≥ 5) groups.
Main Results:
- Significant differences were observed in apnea-hypopnea index (AHI), oxygen desaturation events, and snoring time among the groups.
- Red cell distribution width (RDW) showed a significant difference between the non-OSAS and severe OSAS groups.
- Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were significantly higher in the severe OSAS group (AHI ≥ 5) compared to the non-OSAS group (AHI < 1).
Conclusions:
- NLR, PLR, and RDW levels were significantly elevated in obese children with severe OSAS (AHI ≥ 5).
- These inflammatory markers show potential as diagnostic or severity indicators for OSAS in this population.
- Mean platelet volume (MPV) did not demonstrate a significant correlation with OSAS in the studied children.
Objectives:
To detect whether the mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are contributing factors in the diagnosis and severity of sleep apnea in obese children.
Introduction:
Obesity is a public health problem, and its prevalence increases daily. Although PSG is the gold standard test in the investigation of sleep apnea, the application of this test requires equipment, personnel, time, and cost. There is no simple laboratory test for diagnosing and determining the severity of sleep apnea. Recently, MPV, NLR, and PLR, known as the inflammatory markers in CBC test parameters, have been investigated in some studies. We aim to investigate whether these parameters could provide a method for diagnosing and determining the severity of OSAS in obese children.
Methods:
Clinical records of 180 patients were evaluated. All subjects had venous blood samples collected from the antecubital vein in the morning, after an overnight fasting, one day before PSG. Hemoglobin, RDW, MPV, PLT, platelet distribution width (PDW), and WBC count were measured. After anthropometric and laboratory analysis, 127 obese children were assessed for sleep study. Eighty-three patients who met the required polysomnographic criteria were divided into three groups as follows: group A [non-OSAS, apnea-plus-hypopnea index (AHI) < 1], groupB (1 ≤ AHI < 5), and groupC (AHI ≥ 5).
Results:
Total recording time, total sleep time, sleep efficiency, REM, and NREM sleep stage latency values were not statistically significant among groups. However, the number of awakenings, AHI, oxygen desaturation events, mean oxygen saturation, lowest oxygen saturation, average desaturation, and snoring time values had significant difference among the groups. There was no statistically significant difference among the groups in terms of WBC, Hemoglobin, platelets, PDW, neutrophil, and lymphocyte values. However, RDW values showed a statistically significant difference between groups A and C. Although there was no statistically significant difference of MPV values among groups, NLR and PLR values were statistically significant between groups A and C.
Conclusion:
According to our study, NLR, PLR, and RDW were found to be significantly higher in children whose AHI was ≥5 than in children from the other groups. However, no correlation was found between MPV levels and OSAS in children.
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