Obstruktif Uyku Apne Sendromlu Hastalarda Fibrinojen Düzeylerinin Değerlendirilmesi

Risk of vascular disorders is increased at obstructive sleep apnea syndrome (OSAS) patients. The exact mechanism of development of vascular disease in patients with OSAS remains to be unknown. Fibrinogen is a major constituent of normal plasma. Fibrinogen is an acute phase reactant, with increasing levels as part of the of the acute inflammatory response. Fibrinogen has been shown to be an independent risk factor for coroner heart disease and stroke. Our aim was to compare plasma fibrinogen levels between OSAS and control groups, and relationship with polysomnograhy (PSG) parameters. Fifty patients with newly diagnosed moderate and severe OSAS and 33 non-apneic control subjects were enrolled in this study. Full-night PSG was performed in all patients. Blood samples were drawn at 8:00-9:00 am after the sleep study. Fibrinogen levels were analyzed with Clauss method. There were no significant differences in age, gender, smoking habit between the two groups. Plasma fibrinogen levels in the OSAS group (4.2  ±  0.14 g/L) were significantly higher than that in the control group (p<0.028). Plasma fibrinogen levels were positively correlated with Epworth sleepiness scale (ESS) (r=0.301, p=0.006), age (r=0.327, p=0.003), body mass index (BMI) (r=0.388, p<0.001), average oxygen desaturation (r=0.258, p=0.019), oxygen desaturation index (r=0.281, p=0.010), length of time spent with an oxygen saturation <90% (r=0.248, p=0.024) and arousal index (r=0.220, p=0.046). Plasma fibrinogen levels were negatively correlated with average oxygen saturation during sleep (r= -0.254, p=0.029). Multipl linear regression analyses showed that high ESS and BMI were related with elevated plasma fibrinogen levels, independent of apne hipopne index. In conclusion we suggest that plasma fibrinogen levels correlate with BMI and ESS. The association between plasma fibrinogen levels and nocturnal desaturation supports the linkage between hypoxia and inflamation. We conclude that fibrinogen may be an important factor for development of vascular disease in patients with OSAS.