الفهرس 
Obstructive sleep apnea syndromeOnly 14 pages are availabe for public view
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Abstract
Obstructive sleep apnea syndrome is a common sleep-related breathing disorder characterized by repetitive upper airway collapse during sleep, resulting in a complete (apnea) or partial (hypopnea) obstruction in airflow, reduced oxygen saturation levels which resulting in recurrent episodes of intermittent hypoxia leading to possible frequent interruption of sleep.
OSAS is associated with severe cerebro-cardiovascular morbidity and mortality. It is an independent risk factor for atherosclerosis, arterial thrombosis and metabolic syndrome, and recently has been associated with an increased incidence of cancer and death.
Vitamin D is a fat-soluble vitamin. The vitamin D receptors are widely distributed throughout many tissues, including brain regions involved in sleep regulation and central nervous system. Vitamin D insufficiency may worsen sleep apnea.
Mean platelet volume (MPV) is an indicator of platelet activation. Increased platelet activation plays an important role in the development of cardiovascular complications.
Augmented hypercoagulability has been demonstrated in OSAS patients. Several possible mechanisms such as sympathetic nervous system activation, intermittent hypoxia, oxidative stress markers and inflammation explain the increased cardiovascular disease prevalence in OSAS patients.
The present study aimed at assessing the serum level of vitamin D and MPV in OSAS patients and whether their levels correlate with OSAS severity or not.
The study included 89 subjects who were divided into 2 groups:
group 1: consisted of 65 patients attending to chest and ENT clinics of Menoufia University Hospitals and diagnosed to have Obstructive sleep apnea syndrome in sleep laboratory unit of Chest Department of Menoufia University.
group 2: consisted of 24 healthy volunteers who served as a control group.
Participants who currently use multivitamins or vitamin D supplements or medications that modulate vitamin D metabolism, any participant with known cardiac disease e.g (congestive heart failure, ischemic vascular disease, or arrhythmias) or pulmonary diseases e.g (chronic obstructive pulmonary disease and asthma), any diabetic participant and/or on antidiabetic treatment were excluded.
Participants who have chronic renal or hepatic diseases or endocrinal disorders or who have pure or mainly central apnea on a polysomnographic evaluation were excluded.
Patients on drugs that modify platelet functions and/or number were excluded.
Health Research Ethics Board of Menoufia University approved the study. Informed consent was obtained from all participants, each participant underwent:
Medical full history taking.
Physical examination (general and local).
Chest X-ray (posteroanterior and lateral views).
Routine laboratory investigations
Vitamin D measured by (Human Vitamin D ELISA Kit)
Mean platelet volume (MPV) was measured by Sysmex machine (Automated CBC analyzers).
Epworth sleepiness score (ESS)
Complete overnight polysomnography (PSG)
The results of this study revealed the following:
1. There was no significant difference between patients group and controls group regarding age and sex.
2. The patients demonstrated a significantly higher body mass index and neck circumference than controls.
3. There was a significant lower level of serum vitamin D among patients than controls with non-significant difference between them regarding mean platelet volume level.
4. There was a significant negative correlation between serum vitamin D level among patients and each of neck circumference, Epworth sleepiness scale, apnea hypopnea index, oxygen desaturation index, snoring time and mean platelet volume level.
5. There was a significant positive correlation between mean platelet volume level and each of neck circumference and apnea hypopnea index while it demonstrated a significant negative correlation with serum vitamin D level.
6. Both serum vitamin D level and mean platelet volume differed significantly with the degree of severity of OSAS.
7. Neck circumference was the independent predictor for serum vitamin D levels and MPV in patients with obstructive sleep apnea syndrome.