{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:54:46Z","timestamp":1787612086105,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ARM"],"abstract":"<jats:p>Background and Objectives: Hematological parameters are increasingly being investigated as readily accessible biomarkers for the diagnosis of obstructive sleep apnea syndrome (OSAS). In our study, we aimed to investigate the relationship between OSAS and albumin indices and the uric acid-to-HDL ratio (UHR). Methods: The demographic and laboratory data and AHI (apnea\u2013hypopnea index) values of 613 patients who underwent polysomnography were obtained retrospectively from their files. Blood parameters such as white blood cells (WBCs), red blood cell distribution width (RDW), red blood cells (RBCs), hemoglobin (Hb), hematocrit (Hct), platelets (PLTs), C-reactive protein (CRP), albumin, blood urea nitrogen (BUN), and high-density lipoproteins (HDLs) were obtained from the files. Laboratory indices such as the BUN-to-albumin ratio (BAR), neutrophil-to-albumin ratio (NAR), RDW-to-albumin ratio (RAR), CRP-to-albumin ratio (CAR), and UHR were calculated. OSAS was categorized as simple snoring (SS) (control) (AHI &lt; 5), mild (5 \u2264 AHI &lt; 15), moderate (15 \u2264 AHI &lt; 30), and severe (AHI \u2265 30). The patients were also grouped as severe (AHI \u2265 30) and non-severe (5 &gt; AHI &lt; 30) OSAS and compared in terms of laboratory parameters and indices. Results: Of the 613 participants, 366 (59.7%) were men, and the average age of participants was 55.22 \u00b1 11.13 years. The biomarkers such as RBCs, Hb, Htc, CRP, BUN, creatinine, uric acid, HDLs, CAR, RAR, BAR, and UHR showed significant differences between OSAS patients and controls. WBCs, basophils, RBCs, RDW, Htc, PLTs, HDLs, uric acid, RAR, NAR, and UHR indices were significantly different between the severe OSAS and non-severe OSAS groups (p &lt; 0.05). BAR (OR = 1.151; CI = 1.056 \u2212 1.256; p = 0.001) and UHR (OR = 2.257; 95% CI = 1.507 \u2212 3.382; p &lt; 0.001) were the most important indices predicting OSAS, while RAR (OR = 1.844; CI = 1.224 \u2212 2.778; p = 0.003) and UHR (OR = 2.203; 95% CI = 1.496 \u2212 3.243; p &lt; 0.001) were the strongest indices associated with severe OSAS. Conclusion: In our study, RAR, BAR, and UHR indices were closely associated with the presence and severity of OSAS. These indices can be considered low-cost, readily available methods for predicting OSAS patients.<\/jats:p>","DOI":"10.3390\/arm93050042","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T10:48:07Z","timestamp":1759834087000},"page":"42","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Usefulness of Blood Biomarkers in Screening Patients with Obstructive Sleep Apnea: Could Albumin Indices and Uric Acid-to-HDL Ratio Be New OSAS Severity Indices?"],"prefix":"10.3390","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4198-810X","authenticated-orcid":false,"given":"Mihrican","family":"Ye\u015filda\u011f","sequence":"first","affiliation":[{"name":"Department of Chest Diseases, S.B University Konya Training and Research Hospital, 42090 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha Tahir","family":"Bek\u00e7i","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, S.B University Konya Training and Research Hospital, 42090 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"ref_1","first-page":"1311","article-title":"Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea","volume":"7","author":"Franklin","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1097\/MBC.0b013e32835d53d4","article-title":"The importance of laboratory parameters in patients with obstructive sleep apnea syndrome","volume":"24","author":"Kurt","year":"2013","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Rha, M.S., Kim, C.H., Yoon, J.H., and Cho, H. (2020). Association between the neutrophil-to-lymphocyte ratio and obstructive sleep apnea: A meta-analysis. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-67708-w"},{"key":"ref_4","first-page":"71","article-title":"Hematological evaluation in males with obstructive sleep apnea before and after positive airway pressure","volume":"23","author":"Feliciano","year":"2017","journal-title":"Rev. Port. Pneumol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Maniaci, A., Iannella, G., Cocuzza, S., Vicini, C., Magliulo, G., Ferlito, S., Cammaroto, G., Meccariello, G., De Vito, A., and Nicolai, A. (2021). Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients. J. Clin. Med., 10.","DOI":"10.3390\/jcm10020277"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"479","DOI":"10.5664\/jcsm.6506","article-title":"Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: An American Academy of Sleep Medicine clinical practice guideline","volume":"13","author":"Kapur","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"9681595","DOI":"10.1155\/2021\/9681595","article-title":"Oxidative stress markers among obstructive sleep apnea pwatients","volume":"19","author":"Stanek","year":"2021","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"930535","DOI":"10.1155\/2014\/930535","article-title":"Biomarkers to improve diagnosis and monitoring of obstructive sleep apnea syndrome: Current status and future perspectives","volume":"2014","author":"Archontogeorgis","year":"2014","journal-title":"Pulm. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1177\/1076029616677803","article-title":"Monocyte Count\/ HDL cholesterol ratio and cardiovascular disease in patients with obstructive sleep apnea syndrome: A Multicenter Study","volume":"24","author":"Pazarli","year":"2018","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1001\/jama.2016.18630","article-title":"Screening for obstructive sleep apnea: Implications for the sleep health of the population","volume":"317","author":"Redline","year":"2017","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.sleep.2021.06.040","article-title":"Validation of breath biomarkers for obstructive sleep apnea","volume":"85","author":"Nowak","year":"2021","journal-title":"Sleep Med."},{"key":"ref_12","first-page":"4027","article-title":"Do Complete Blood Count Parameters Predict Diagnosis and Disease Severity in Obstructive Sleep Apnea Syndrome?","volume":"11","author":"Zorlu","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.cca.2016.06.046","article-title":"Biomarkers of cardiovascular stress in obstructive sleep apnea","volume":"460","author":"Maeder","year":"2016","journal-title":"Clin. Chim Acta"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5664\/jcsm.4358","article-title":"Diagnostic capability of biological markers in assessment of obstructive sleep apnea: A systematic review and meta-analysis","volume":"11","author":"Aydinoz","year":"2015","journal-title":"J. Clin. Sleep Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6509","DOI":"10.21037\/jtd.2018.10.105","article-title":"Hematological indices as simple, inexpensive and practical severity markers of obstructive sleep apnea syndrome: A meta-analysis","volume":"10","author":"Wu","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.ajem.2021.01.053","article-title":"NLR and CRP to albumin ratio as a predictor of in-hospital mortality in the geriatric ED patients","volume":"44","author":"Dundar","year":"2021","journal-title":"Am. J. Emerg. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1097\/MBC.0b013e32835e98da","article-title":"Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases","volume":"24","author":"Kanbay","year":"2013","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5003","DOI":"10.1007\/s12070-021-02613-w","article-title":"Role of neutrophil to lymphocyte ratio in predicting severity of obstructive sleep apnea","volume":"74","author":"Shetty","year":"2022","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"477","DOI":"10.12659\/MSM.893175","article-title":"Evoluation of the association of sleep apnea related systemic inflammation with CRP, ESR, and neutrophil-to-lymphocyte ratio","volume":"21","author":"Korkmaz","year":"2015","journal-title":"Med. Sci. Monit."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Merlot, A.M., Kalinowski, D.S., and Richardson, D.R. (2014). Unraveling the mysteries of serum albumin-more than just a serum protein. Front. Physiol., 5.","DOI":"10.3389\/fphys.2014.00299"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Arihan, O., Wernly, B., Lichtenauer, M., Franz, M., Kabisch, B., Muessig, J., Masyuk, M., Alexander Lauten, A., Paul Christian Schulze, P.C., and Uta C Hoppe, U.C. (2018). Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191697"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"377","DOI":"10.2147\/NSS.S226143","article-title":"Nocturnal mean oxygen saturation is associated with secondary polycythemia in young adults with obstructive sleep apnea, especially in Men","volume":"11","author":"Li","year":"2018","journal-title":"Nat. Sci. Sleep"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Su, Y.C., Wen, S.C., Li, C.C., Su, H.C., Ke, H.L., Li, W.M., Lee, H.Y., Li, C.Y., Yang, S.F., and Tu, H.P. (2021). Low Hemoglobin-to-Red Cell Distribution Width Ratio Is Associated with Disease Progression and Poor Prognosis in Upper Tract Urothelial Carcinoma. Biomedicines, 9.","DOI":"10.3390\/biomedicines9060672"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Tan, N., He, Y., Li, G., and Liu, P. (2025). Clinical significance of the hemoglobin-to-red blood cell distribution width ratio in patients with severe OSAS. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-96693-1"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5664\/jcsm.6576","article-title":"AASM Scoring Manual Updates for 2017 (Version 2.4)","volume":"13","author":"Berry","year":"2017","journal-title":"J. Clin. Sleep Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s11325-017-1544-z","article-title":"Combination mode of physiological signals for diagnosis of OSAS using portable monitor","volume":"22","author":"Jiang","year":"2018","journal-title":"Sleep Breath."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.5664\/jcsm.6064","article-title":"Quality measure for screening for adult obstructive sleep apnea by primary care physicians","volume":"12","author":"Aurora","year":"2016","journal-title":"J. Clin. Sleep Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jjcc.2015.06.005","article-title":"The relationship between neutrophil to lymphocyte ratio, endothelial function, and severity in patients with obstructive sleep apnea","volume":"67","author":"Oyama","year":"2016","journal-title":"J. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1111\/crj.12765","article-title":"Gamma-glutamyl transferase activity as a predictive marker for severity of obstructive sleep apnea syndrome and concomitant hypertension","volume":"12","author":"Bozkus","year":"2018","journal-title":"Clin. Respir. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1183\/09031936.00050410","article-title":"Free fatty acids and the metabolic syndrome in patients with obstructive sleep apnoea","volume":"37","author":"Esquinas","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1111\/crj.12718","article-title":"Changes in inflammatory mediators as a result of intermittent hypoxia in obstructive sleep apnea syndrome","volume":"12","author":"Sozer","year":"2018","journal-title":"Clin. Respir. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1097\/MEG.0000000000002439","article-title":"The correlation between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with non-alcoholic fatty liver disease: A crosssectional study","volume":"34","author":"Zhou","year":"2022","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"296","DOI":"10.4274\/imj.galenos.2022.29794","article-title":"A Comparison of BUN\/Albumin Ratio with PSI and CURB-65 for Predicting Mortality in COVID-19 Pneumonia in the Emer gency Department","volume":"23","author":"Efgan","year":"2022","journal-title":"\u0130stanbul Med. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ajem.2021.03.090","article-title":"The role of the BUN\/albumin ratio in predicting mortality in COVID-19 patients in the emergency department","volume":"48","year":"2021","journal-title":"Am. J. Emerg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1002\/jso.25209","article-title":"NARCA: A novel prognostic scoring system using neutrophil-albumin ratio and Ca19-9 to predict overall survival in palliative pancreatic cancer","volume":"118","author":"Tingle","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3109\/10408363.2014.992064","article-title":"Red blood cell distribution width: A simple parameter with multiple clinical applications","volume":"52","author":"Salvagno","year":"2015","journal-title":"Crit. Rev. Clin. Lab. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.amjcard.2012.12.034","article-title":"Association of serum uric acid and cardiovascular disease in healthy adults","volume":"111","author":"Kivity","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s12944-025-02604-8","article-title":"Association of serum uric acid-to-high-density lipoprotein cholesterol ratio with obstructive sleep apnea: A cross-sectional study","volume":"24","author":"Tang","year":"2025","journal-title":"Lipids Health Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S0167-5273(00)00221-7","article-title":"Protective effect of high-density lipoprotein on endothelium-dependent vasodilatation","volume":"73","author":"Li","year":"2000","journal-title":"Int. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e551","DOI":"10.1016\/j.clml.2019.06.005","article-title":"High Red Cell Distribution Width is an Adverse Predictive and Prognostic Factor in Patients with Diffuse Large B-Cell Lymphoma Treated with Chemoimmunotherapy","volume":"19","author":"Beltran","year":"2019","journal-title":"Clin. Lymphoma Myeloma Leuk."}],"container-title":["Advances in Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2543-6031\/93\/5\/42\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:49:55Z","timestamp":1760035795000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2543-6031\/93\/5\/42"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,7]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["arm93050042"],"URL":"https:\/\/doi.org\/10.3390\/arm93050042","relation":{},"ISSN":["2543-6031"],"issn-type":[{"value":"2543-6031","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,7]]}}}