Neutrophil-to-Lymphocyte Ratio and Carotid Artery Calcified Plaque in Older Male Patients With Severe Obstructive Sleep Apnea

I have read with interest the article by Lee et al, 1 Lee U.K. Liu S.Y. Zeidler M.R. et al. Severe obstructive sleep apnea with imaged carotid plaque is significantly associated with systemic inflammation. J Oral Maxillofac Surg. 2019; 77: 1636 Abstract Full Text Full Text PDF Scopus (4) Google Scholar who conducted a cross-sectional study to compare the neutrophil-to-lymphocyte ratio (NLR) between groups with and without carotid artery calcified plaque (CACP) in older male patients with severe obstructive sleep apnea (OSA). The authors observed that the mean NLP value of OSA patients with CACP was significantly higher than that of OSA patients without CACP. In contrast, cardiovascular risk factors such as age, body mass index, hypertension, and diabetes showed no significant association with NLR and CACP. I have some concerns about the study. Severe Obstructive Sleep Apnea With Imaged Carotid Plaque Is Significantly Associated With Systemic InflammationJournal of Oral and Maxillofacial SurgeryVol. 77Issue 8PreviewPersons with obstructive sleep apnea (OSA) are at heightened risk of myocardial infarction (MI) and stroke caused by adiposity and intermittent hypoxia, which provoke proinflammatory cytokines to induce systemic and vascular inflammation, resulting in endothelial dysfunction and development of atherosclerotic plaque. This study compared levels of systemic inflammation, as indexed by the neutrophil-to-lymphocyte ratio (NLR), between groups of patients with severe OSA with and without carotid artery calcified plaque (CACP+ and CACP−, respectively) on their panoramic image (PI). Full-Text PDF