Changes And Clinical Significance Of The Ratio Of Monocyte Count To High Density Lipoprotein Cholesterol In Patients With OSAHS

Objective: at present,obstructive sleep apnea hypopnea syndrome（OSAHS）is a common sleep disorder,and severe patients are often complicated with multiple system complications.at present,the disease classification is mainly based on the sleep apnea hypopnea index（AHI）.There are no other indicators to predict the severity of OSAHS.Monocyte count to high density lipoprotein cholesterol and its ratio can be used as an indicator of inflammation in cardiovascular and cerebrovascular diseases,but it is rarely reported in OSAHS.The purpose of this study was to study the clinical significance of monocyte count,high density lipoprotein cholesterol and its ratio（MHR）in the severity of OSAHS,and to provide a reference basis for clinicians to evaluate the severity of OSAHS.Methods: A total of 596 patients who underwent sleep breathing monitoring in the Sleep Monitoring Center of the first Hospital of Lanzhou University from January2019 to December 2020 were collected.The subjects were divided into mild（5 ≤ AHI< 15）,moderate（15 ≤ AHI < 30）and severe（≥ 30）according to sleep apnea hypopnea index（AHI）.The basic data such as the patient’s history,monocyte count and high density lipoprotein cholesterol in the results of blood routine and biochemical examination in the first hospitalization were collected,and the relationship between MHR and the severity of OSAHS disease was analyzed.Results:1.Chi-square test showed that there was no significant difference in gender,hypertension,coronary atherosclerotic heart disease and diabetes among mild,moderate and severe OSAHS groups（P > 0.05）.2.Through one-way ANOVA analysis of age,BMI,triglyceride,monocyte absolute value,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）and MHR among different severity groups of OSAHS,it was found that there were significant differences in BMI,HDL-C,monocyte absolute value and MHR.Pairwise comparison showed that with the increase of the severity of OSAHS,BMI,absolute value of monocytes and MHR gradually increased,while HDL-C gradually decreased.3.The indexes with statistically significant differences in univariate analysis were analyzed by multi-factor ordered regression analysis.Taking the severity of OSAHS as dependent variable,BMI,monocyte absolute value,HDL-C and MHR as independent variables,multivariate ordered regression analysis showed that BMI,monocyte absolute value,HDL-C and MHR were statistically significant.It can be considered that BMI,monocyte absolute value,HDL-C and MHR are independent risk factors for the severity of OSAHS.4.The correlation analysis of Pearson between AHI,nocturnal lowest Sa O2 and MHR,absolute value of monocytes and HDL-C showed that AHI and nocturnal lowest Sa O2 were significantly correlated with absolute value of monocytes,HDL-C and MHR.AHI was positively correlated with the absolute value of monocytes and MHR（r = 0.190,p < 0.001,r = 0.214,p < 0.001）,and negatively correlated with HDL-C（r = 0.168,P < 0.001）,and the lowest Sa O2 at night was negatively correlated with absolute values of monocytes and MHR（r = 0.156,p < 0.001,r = 0.213,p <0.001）,and positively correlated with HDL-C（r = 0.161,p < 0.001）.5.MHR also had statistical significance in OSAHS patients with hypertension,diabetes mellitus and coronary atherosclerotic heart disease.Conclusion:1.There is a positive correlation between MHR and the severity of OSAHS2.MHR is closely related to OSAHS-related complications such as hypertension,diabetes and coronary heart disease3.MHR has certain clinical significance in predicting the severity of OSAHS and its complications.