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Evaluation of MIh Scoring System in Diagnosis of Obstructive Sleep Apnea Syndrome

Qinxing Xu, Junwei Du, Xiaobo Ling, Yangfei Lu

Department of Respiratory Medicine, Hangzhou Fuyang First People’s Hospital, Hangzhou, Zhejiang, China (mainland)

Med Sci Monit 2017; 23:4715-4722

DOI: 10.12659/MSM.904087

Available online:

Published: 2017-10-02

BACKGROUND: The objective of the present study was to investigate whether the analysis of magnesium (Mg), high-sensitivity C-reactive protein (hsCRP), and ischemia-modified albumin (IMA) concentrations can be used as a non-invasive and convenient method for diagnosing obstructive sleep apnea syndrome (OSAS).
MATERIAL AND METHODS: After polysomnography, venous blood was collected from 33 patients with OSAS and 30 control individuals. Serum levels of Mg, hsCRP, and IMA were investigated. The relationship between these factors and apnea–hypopnea index (AHI) was analyzed using the Pearson correlation coefficient. The role of the factors was determined using a receiver operating characteristic (ROC) curve and multivariate logistic regression analysis.
RESULTS: The levels of hsCRP and IMA were significantly higher in patients with OSAS than in control subjects, while the levels of Mg were lower (P<0.05 for all). A significant correlation was noted between serum IMA (r=0.614; P<0.001) and hsCRP (r=0.453; P<0.001) levels and the AHI. The ROC showed that serum Mg (AUC=0.74(0.62–0.85)), hsCRP (AUC=0.77(0.65–0.87)), and IMA (AUC=0.78(0.66–0.87)) levels could be used as markers to diagnose OSAS. Moreover, our new model, MIh, which is obtained by multivariate analysis, yielded an AUC value of 0.93 (0.83–0.98). Continuous positive airway pressure (CPAP) treatment reversed the changes in the serum levels of Mg, hsCRP, and IMA.
CONCLUSIONS: Patients with OSAS show reduced serum Mg levels and elevated serum hsCRP and IMA levels. These observed alterations can be reversed by CPAP treatment. A novel model, named MIh, may be a promising tool for OSAS diagnosis.

Keywords: C-Reactive Protein, Diagnosis, Magnesium Deficiency, Sleep apnea, obstructive