Monocyte/HDL Cholesterol Ratio and Matrix Metalloproteinase-2 in Obstructive Sleep Apnea Syndrome Without Heart Disease

Objective: Long waiting periods for polysomnography (PSG) may delay the diagnosis of obstructive sleep apnea syndrome.We aimed to assess the value of the serum monocyte/high-density lipoprotein (HDL) cholesterol ratio and matrix metalloproteinase (MMP)-2 levels in the early diagnosis and determination of disease severity.Materials and Methods: This cross-sectional analytical study enrolled 162 adult participants-31 with mild, 38 with moderate, and 47 with severe disease and 46 non-affected controls.The clinical and demographic data and the ratio and MMP-2 levels were recorded and compared.Results: A ratio >8.78 discriminated between cases with and without the condition, with a 73.3% sensitivity and 60.9% specificity (p=0.004).A serum MMP-2 level 4.01 ng/mL was also effective, with a 75% sensitivity and 50% specificity (p=0.012).There was a significant positive correlation between the serum monocyte/HDL cholesterol ratio and disease severity, with a 38% sensitivity and 92% specificity (p=0.025),but an insignificant negative correlation with metalloproteinase-2 level.The ratio, but not MMP-2 level, was significantly higher in affected subgroups than in the controls.Reanalysis of risk factors using a multivariate model revealed that higher HDL and metalloproteinase-2 levels were associated with a decreased likelihood of developing the condition.Conclusion: Assessment of the serum monocyte/HDL cholesterol ratio and MMP-2 levels may be useful as rapid and low-cost methods for identifying the condition, and the former may help predict disease severity.Evaluation of these parameters may help plan PSG when obstructive sleep apnea is suspected.