The effect of compliance with PAP therapy on biochemical parameters in patients with obstructive sleep apnea syndrome: A 6-month follow-up study.

Introduction: The gold standard treatment for obstructive sleep apnea syndrome (OSAS) is positive airway pressure therapy (PAP) treatments. PAP treatments reduce complications by reducing apnea and hypopnea attacks by creating airflow at a determined pressure. In our study, we aimed to examine the effect of treatment compliance on kidney and liver functions, apneahypopnea (AHI) index, and lipid profile of patients diagnosed with OSAS and started PAP treatment. Materials and Methods: Patients who were admitted to the sleep laboratory of our hospital between September 2022 and September 2023 and started PAP treatment after PSG were included in our study. Patients who were called for follow-up six months after the initiation of PAP treatment were divided into two groups according to their compliance with PAP treatment. Patients who used the device for at least four hours per night and more than 70% at night were grouped as PAP-compliant patients, while the other patients were grouped as non-PAP-compliant patients. Result: It was observed that uric acid, BUN, triglyceride, total cholesterol, ALT, GGT, ALP, and AHI levels of the patients who started PAP treatment decreased after six months (p= 0.001, 0.006, <0.001, 0.006, 0.01, <0.001, <0.001, <0.001 with). It was observed that HDL cholesterol levels increased (p≤ 0.001). It was observed that the change in uric acid, AHI, total cholesterol, and GGT levels in group 1 (n= 36) patients who were compliant with PAP treatment was statistically higher than in group 2 (n= 30) patients (p< 0.001, <0.03, <0.001, 0.008, respectively). Conclusions: Uric acid, total cholesterol and GGT are biomarkers that may increase in OSAS due to intermittent hypoxia with the involvement of other systems. Since a decrease in these biomarkers can be observed in the early period depending on treatment compliance, these biomarkers can be used practically in the follow-up of treatment compliance and treatment efficacy.

Evaluation of serum YKL-40 level among clinical risk scores for early mortality in acute pulmonary thromboembolism.

INTRODUCTION: Pulmonary embolism (PE) often occurs secondary to deep vein thrombosis and is an important cause of mortality and morbidity. This study aimed to evaluate the relationship between YKL-40 level and clinical risk score in patients with PE. METHODS: The study included a total of 100 patients, 80 patients diagnosed with PE in the emergency department and 20 healthy controls. Patients with PE were divided into four groups: high-risk patients (n = 20), high-intermediate-risk patients (n = 20), low-intermediate-risk patients (n = 20), and low-risk patients (n = 20). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. Pulmonary artery obstruction index (PAOI) was calculated from computed tomography angiography images. RESULTS: PAOI increased in correlation with PE risk and differed significantly between all patient groups (p < 0.001). Troponin-I levels were significantly higher in the high-risk and high-intermediate-risk groups compared to the other groups (p < 0.001), but did not differ significantly between high-risk and high-intermediate-risk patients (p = 0.09). YKL-40 level was significantly higher in the high-risk PE group than the high-intermediate-risk group (p < 0.001). In receiving operator characteristic curve analysis assessing the discriminatory value of YKL-40 for high-risk PE patients, a cut-off value of 227.2 ng/mL had sensitivity of 85 % and specificity of 70 %. DISCUSSION: YKL-40 may be an important biomarker in decisions regarding early thrombolytic treatment in patients with high-intermediate-risk PE. In addition, medical treatments targeting YKL-40 may also reduce thrombotic tendency in high-risk patient groups.