Association between Red Blood Cell Distribution Width and Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-Analysis
Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic...
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| Published in | Journal of clinical medicine Vol. 12; no. 9; p. 3302 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Switzerland
MDPI AG
05.05.2023
MDPI |
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| Online Access | Get full text |
| ISSN | 2077-0383 2077-0383 |
| DOI | 10.3390/jcm12093302 |
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| Abstract | Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, p < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO2) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047). |
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| AbstractList | Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, p < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO2) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047).Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, p < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO2) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047). Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, p < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO2) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047). Although polysomnography is the gold standard method to diagnose obstructive sleep apnea syndrome (OSAS), there is an ongoing quest for simpler and relatively inexpensive biomarkers of disease presence and severity. To address this issue, we conducted a systematic review of the potential diagnostic role of the red blood cell distribution width (RDW), a routine hematological parameter of red blood cell volume variability, in OSAS. A total of 1478 articles were initially identified in the databases PubMed, Web of Science, Scopus, Embase, and Google Scholar, from their inception to February 2023, and 20 were selected for final analysis. The RDW was significantly higher in OSAS than in non-OSAS subjects (SMD = 0.44, 95% CI 0.20 to 0.67, < 0.001; low certainty of evidence). In univariate meta-regression, the mean oxygen saturation (SpO ) was significantly associated with the effect size. No significant between-group differences were observed in subgroup analyses. Notably, in OSAS subjects, the RDW SMD progressively increased with disease severity. In conclusion, these results suggest that the RDW is a promising biomarker of OSAS (PROSPERO registration number: CRD42023398047). |
| Author | Paliogiannis, Panagiotis Zinellu, Angelo Fois, Alessandro G. Pau, Maria Carmina Zinellu, Elisabetta Pirina, Pietro Carru, Ciriaco Mangoni, Arduino A. Di Lorenzo, Biagio |
| AuthorAffiliation | 1 Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy 4 Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedfor Park, SA 5042, Australia 2 Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy 3 Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy 5 Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia 6 Quality Control Unit, University Hospital of Sassari (AOU), 07100 Sassari, Italy |
| AuthorAffiliation_xml | – name: 3 Clinical and Interventional Pulmonology, University Hospital of Sassari (AOU), 07100 Sassari, Italy – name: 4 Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedfor Park, SA 5042, Australia – name: 5 Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia – name: 1 Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy – name: 6 Quality Control Unit, University Hospital of Sassari (AOU), 07100 Sassari, Italy – name: 2 Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy |
| Author_xml | – sequence: 1 givenname: Biagio surname: Di Lorenzo fullname: Di Lorenzo, Biagio – sequence: 2 givenname: Maria Carmina surname: Pau fullname: Pau, Maria Carmina – sequence: 3 givenname: Elisabetta surname: Zinellu fullname: Zinellu, Elisabetta – sequence: 4 givenname: Arduino A. orcidid: 0000-0001-8699-1412 surname: Mangoni fullname: Mangoni, Arduino A. – sequence: 5 givenname: Panagiotis orcidid: 0000-0001-5485-6056 surname: Paliogiannis fullname: Paliogiannis, Panagiotis – sequence: 6 givenname: Pietro orcidid: 0000-0003-1457-8025 surname: Pirina fullname: Pirina, Pietro – sequence: 7 givenname: Alessandro G. orcidid: 0000-0001-5330-572X surname: Fois fullname: Fois, Alessandro G. – sequence: 8 givenname: Ciriaco orcidid: 0000-0002-6985-4907 surname: Carru fullname: Carru, Ciriaco – sequence: 9 givenname: Angelo orcidid: 0000-0002-8396-0968 surname: Zinellu fullname: Zinellu, Angelo |
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| Keywords | obstructive sleep apnea syndrome biomarker disease severity red blood cell distribution width |
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