SLEEP OBSTRUCTIVE APNEA SYNDROME (SOAS) IS NOT ASSOCIATED WITH MARKED ERYTHROCYTOSIS. A STUDY ON 337 PATIENTS
(Abstract release date: 05/19/16)
EHA Library. morel p. 06/09/16; 133036; E1487
Dr. pierre morel
Contributions
Contributions
Abstract
Abstract: E1487
Type: Eposter Presentation
Background
Normal values of hemoglobin concentration (Hb) and hematocrit (Ht) depend on gender only.
Aims
To check the role of age and frequent disorders that may influence erythropoiesis (renal function, iron metabolism and oxygenation abnormality).
Methods
This prospective study enrolled 337 patients (pts) aged 16 to 88 years (median 61, M/F=1.51) referred to the sleep unit of Hospital of Lens. All patients had arterial blood gas, blood cell count and routine chemistry. Apnea hypopnea index (AHI) was available in 250 pts.
Results
Severe SOAS (AHI>30/hour) was found in 121 pts (48% of evaluated pts). Median HB and HT was 13.3 g/dL (range from 8.5 to 17.2 g/dL) and 40.7% (range 18,1 to 51,4%) respectively. Only 5 pts presented with increased HB (>17.5 g/dL in male, >15.5 g/dL in female) and HT (>50% in male and >47% in female). Conversely, anemia (HB <13.5 g/dL in male, <12.5 g/dL in female or HT <40% in male, <37% in female) was present in 118 pts (35%): Renal failure (MDRD creatinine clearance <60 ml/min), iron deficiency (ferritin <30 µg/L) or features of anemia of chronic disease (CRP>10 mg/L or ferritin >400 µg/L) were observed in 84 (25%), 58 (17%) and 72 (21%) pts respectively. Finally, 173 pts presented none of these disorders (no cause of anemia) and 219 pts presented without anemia according to HB and HT criteria (non-anemic pts). Female pts had lower HB and HT than male pts (median 12.6 g/dL and 38.5% vs. 13.9 g/dL and 42.4%,respectively, p<0.0001). HB and HT were mainly influenced by age and also MDRD creatinine clearance (that takes age and gender into account) (table 1). The relationships between age and HB and HT were confirmed in linear models (R2=0.133 and 0.118, respectively, p<0.0001) and these inverse relationships were validated in an independent seris of 3892 patients referred in the medicine units of the Centre Hospitalier Universitaire of Amiens. Testing the lack of fit showed that the linear model was inadequate in the subgroup of male pts, and smoothing spline analysis showed an increase in the inverse relationship between HB and age in elderly male pts older than 60 years.Table 1: Spearman’s correlation coefficient (r) between HB and HT and explicative variables
AHI was the only respiratory parameter that influenced only HB (r=0.13085, p=0.047). There was no significant correlation between AHI and age, no significant difference in the distribution of AHI in male and female. Nevertheless, significant correlations were observed between AHI and HB and HT when the analyses were performed in the non anemic pts (r=0.20676, p= 0.0067 and r= 0.18340, p=0.0163 respectively) and in pts without cause of anemia (r= 0.20092, p=0.0224 and r= 0.16335 p= 0.0644 respectively)
Conclusion
This prospective study showed an inverse relationship between age and HB and HT. We confirmed the rarity of marked erythrocytosis in pts with SOAS and the weak correlation between AHI and HB and HT. Our data suggested that SOAS pts also frequently present with characteristics that may play a part in reducing HB and HT. Thus, checking the presence or the absence of associated comorbidity should be considered in SOAS pts with erythrocytosis.
Session topic: E-poster
Keyword(s): Erythrocytosis
Type: Eposter Presentation
Background
Normal values of hemoglobin concentration (Hb) and hematocrit (Ht) depend on gender only.
Aims
To check the role of age and frequent disorders that may influence erythropoiesis (renal function, iron metabolism and oxygenation abnormality).
Methods
This prospective study enrolled 337 patients (pts) aged 16 to 88 years (median 61, M/F=1.51) referred to the sleep unit of Hospital of Lens. All patients had arterial blood gas, blood cell count and routine chemistry. Apnea hypopnea index (AHI) was available in 250 pts.
Results
Severe SOAS (AHI>30/hour) was found in 121 pts (48% of evaluated pts). Median HB and HT was 13.3 g/dL (range from 8.5 to 17.2 g/dL) and 40.7% (range 18,1 to 51,4%) respectively. Only 5 pts presented with increased HB (>17.5 g/dL in male, >15.5 g/dL in female) and HT (>50% in male and >47% in female). Conversely, anemia (HB <13.5 g/dL in male, <12.5 g/dL in female or HT <40% in male, <37% in female) was present in 118 pts (35%): Renal failure (MDRD creatinine clearance <60 ml/min), iron deficiency (ferritin <30 µg/L) or features of anemia of chronic disease (CRP>10 mg/L or ferritin >400 µg/L) were observed in 84 (25%), 58 (17%) and 72 (21%) pts respectively. Finally, 173 pts presented none of these disorders (no cause of anemia) and 219 pts presented without anemia according to HB and HT criteria (non-anemic pts). Female pts had lower HB and HT than male pts (median 12.6 g/dL and 38.5% vs. 13.9 g/dL and 42.4%,respectively, p<0.0001). HB and HT were mainly influenced by age and also MDRD creatinine clearance (that takes age and gender into account) (table 1). The relationships between age and HB and HT were confirmed in linear models (R2=0.133 and 0.118, respectively, p<0.0001) and these inverse relationships were validated in an independent seris of 3892 patients referred in the medicine units of the Centre Hospitalier Universitaire of Amiens. Testing the lack of fit showed that the linear model was inadequate in the subgroup of male pts, and smoothing spline analysis showed an increase in the inverse relationship between HB and age in elderly male pts older than 60 years.Table 1: Spearman’s correlation coefficient (r) between HB and HT and explicative variables
| Characteristics | HB | HT | ||
| Age | r= -0.34650 | p<.0001 | r= -0.32086 | p <.0001 |
| Creatinine clearance (MDRD) | r=0.23686 | p<.0001 | r=0.21106 | p=0.0003 |
| Ferritin | r=0.30928 | p<.0001 | r=0.13743 | p=0.016 |
| CRP | r=-0.12961 | p=0.0227 | r=-0.10795 | p=0.058 |
| AHI | r=0.13085 | p=0.047 | r=0.11799 | p=0.0735 |
Conclusion
This prospective study showed an inverse relationship between age and HB and HT. We confirmed the rarity of marked erythrocytosis in pts with SOAS and the weak correlation between AHI and HB and HT. Our data suggested that SOAS pts also frequently present with characteristics that may play a part in reducing HB and HT. Thus, checking the presence or the absence of associated comorbidity should be considered in SOAS pts with erythrocytosis.
Session topic: E-poster
Keyword(s): Erythrocytosis
Abstract: E1487
Type: Eposter Presentation
Background
Normal values of hemoglobin concentration (Hb) and hematocrit (Ht) depend on gender only.
Aims
To check the role of age and frequent disorders that may influence erythropoiesis (renal function, iron metabolism and oxygenation abnormality).
Methods
This prospective study enrolled 337 patients (pts) aged 16 to 88 years (median 61, M/F=1.51) referred to the sleep unit of Hospital of Lens. All patients had arterial blood gas, blood cell count and routine chemistry. Apnea hypopnea index (AHI) was available in 250 pts.
Results
Severe SOAS (AHI>30/hour) was found in 121 pts (48% of evaluated pts). Median HB and HT was 13.3 g/dL (range from 8.5 to 17.2 g/dL) and 40.7% (range 18,1 to 51,4%) respectively. Only 5 pts presented with increased HB (>17.5 g/dL in male, >15.5 g/dL in female) and HT (>50% in male and >47% in female). Conversely, anemia (HB <13.5 g/dL in male, <12.5 g/dL in female or HT <40% in male, <37% in female) was present in 118 pts (35%): Renal failure (MDRD creatinine clearance <60 ml/min), iron deficiency (ferritin <30 µg/L) or features of anemia of chronic disease (CRP>10 mg/L or ferritin >400 µg/L) were observed in 84 (25%), 58 (17%) and 72 (21%) pts respectively. Finally, 173 pts presented none of these disorders (no cause of anemia) and 219 pts presented without anemia according to HB and HT criteria (non-anemic pts). Female pts had lower HB and HT than male pts (median 12.6 g/dL and 38.5% vs. 13.9 g/dL and 42.4%,respectively, p<0.0001). HB and HT were mainly influenced by age and also MDRD creatinine clearance (that takes age and gender into account) (table 1). The relationships between age and HB and HT were confirmed in linear models (R2=0.133 and 0.118, respectively, p<0.0001) and these inverse relationships were validated in an independent seris of 3892 patients referred in the medicine units of the Centre Hospitalier Universitaire of Amiens. Testing the lack of fit showed that the linear model was inadequate in the subgroup of male pts, and smoothing spline analysis showed an increase in the inverse relationship between HB and age in elderly male pts older than 60 years.Table 1: Spearman’s correlation coefficient (r) between HB and HT and explicative variables
AHI was the only respiratory parameter that influenced only HB (r=0.13085, p=0.047). There was no significant correlation between AHI and age, no significant difference in the distribution of AHI in male and female. Nevertheless, significant correlations were observed between AHI and HB and HT when the analyses were performed in the non anemic pts (r=0.20676, p= 0.0067 and r= 0.18340, p=0.0163 respectively) and in pts without cause of anemia (r= 0.20092, p=0.0224 and r= 0.16335 p= 0.0644 respectively)
Conclusion
This prospective study showed an inverse relationship between age and HB and HT. We confirmed the rarity of marked erythrocytosis in pts with SOAS and the weak correlation between AHI and HB and HT. Our data suggested that SOAS pts also frequently present with characteristics that may play a part in reducing HB and HT. Thus, checking the presence or the absence of associated comorbidity should be considered in SOAS pts with erythrocytosis.
Session topic: E-poster
Keyword(s): Erythrocytosis
Type: Eposter Presentation
Background
Normal values of hemoglobin concentration (Hb) and hematocrit (Ht) depend on gender only.
Aims
To check the role of age and frequent disorders that may influence erythropoiesis (renal function, iron metabolism and oxygenation abnormality).
Methods
This prospective study enrolled 337 patients (pts) aged 16 to 88 years (median 61, M/F=1.51) referred to the sleep unit of Hospital of Lens. All patients had arterial blood gas, blood cell count and routine chemistry. Apnea hypopnea index (AHI) was available in 250 pts.
Results
Severe SOAS (AHI>30/hour) was found in 121 pts (48% of evaluated pts). Median HB and HT was 13.3 g/dL (range from 8.5 to 17.2 g/dL) and 40.7% (range 18,1 to 51,4%) respectively. Only 5 pts presented with increased HB (>17.5 g/dL in male, >15.5 g/dL in female) and HT (>50% in male and >47% in female). Conversely, anemia (HB <13.5 g/dL in male, <12.5 g/dL in female or HT <40% in male, <37% in female) was present in 118 pts (35%): Renal failure (MDRD creatinine clearance <60 ml/min), iron deficiency (ferritin <30 µg/L) or features of anemia of chronic disease (CRP>10 mg/L or ferritin >400 µg/L) were observed in 84 (25%), 58 (17%) and 72 (21%) pts respectively. Finally, 173 pts presented none of these disorders (no cause of anemia) and 219 pts presented without anemia according to HB and HT criteria (non-anemic pts). Female pts had lower HB and HT than male pts (median 12.6 g/dL and 38.5% vs. 13.9 g/dL and 42.4%,respectively, p<0.0001). HB and HT were mainly influenced by age and also MDRD creatinine clearance (that takes age and gender into account) (table 1). The relationships between age and HB and HT were confirmed in linear models (R2=0.133 and 0.118, respectively, p<0.0001) and these inverse relationships were validated in an independent seris of 3892 patients referred in the medicine units of the Centre Hospitalier Universitaire of Amiens. Testing the lack of fit showed that the linear model was inadequate in the subgroup of male pts, and smoothing spline analysis showed an increase in the inverse relationship between HB and age in elderly male pts older than 60 years.Table 1: Spearman’s correlation coefficient (r) between HB and HT and explicative variables
| Characteristics | HB | HT | ||
| Age | r= -0.34650 | p<.0001 | r= -0.32086 | p <.0001 |
| Creatinine clearance (MDRD) | r=0.23686 | p<.0001 | r=0.21106 | p=0.0003 |
| Ferritin | r=0.30928 | p<.0001 | r=0.13743 | p=0.016 |
| CRP | r=-0.12961 | p=0.0227 | r=-0.10795 | p=0.058 |
| AHI | r=0.13085 | p=0.047 | r=0.11799 | p=0.0735 |
Conclusion
This prospective study showed an inverse relationship between age and HB and HT. We confirmed the rarity of marked erythrocytosis in pts with SOAS and the weak correlation between AHI and HB and HT. Our data suggested that SOAS pts also frequently present with characteristics that may play a part in reducing HB and HT. Thus, checking the presence or the absence of associated comorbidity should be considered in SOAS pts with erythrocytosis.
Session topic: E-poster
Keyword(s): Erythrocytosis
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