Author Identifier (ORCID)
Abstract
Objectives: This study aimed to investigate the impact of Obstructive Sleep Apnea (OSA) on immune cell profiles by utilizing both the National Health and Nutrition Examination Survey (NHANES) dataset and a two-sample Mendelian Randomization (MR) method. Methods: We included 20,732 participants from the NHANES to explore the relationship between symptom defined OSA and peripheral immune cells. Additionally, we conducted a two-sample MR analysis to investigate the effect of OSA on 35 summarized peripheral immune cell properties and 731 immunophenotypes. To ensure the robustness of findings in MR analysis, we conducted a sensitivity analysis. Results: The NHANES dataset and MR analysis indicated that OSA patients exhibit significantly elevated levels of white blood cells, neutrophils, and granulocytes, along with lower levels of lymphocytes. Furthermore, the MR analysis demonstrated a causal link between genetic predisposition to OSA and ten lymphocyte subtypes. Notably, there is a decrease in CD3 expression on Natural Killer-T (NKT) cells (βIVW = −0.47, SE = 0.17, p = 0.005), and an increase in lgD expression on lgD + CD38+ B-cells (βIVW = 0.36, SE = 0.15, p = 0.020) among individuals with a genetic predisposition to OSA. No heterogeneity or pleiotropy was identified. Conclusion: OSA is associated with elevated neutrophils, granulocytes, and systemic immune-inflammation index. Causally, OSA reduces NKT cells and disrupts lymphocyte homeostasis, impairing B-cell maturation/activation. These immune signatures may serve as clinical biomarkers for guide risk stratification and guide personalized therapies, including targeted immunomodulation. Level of evidence: This study combined a cross-sectional analysis of NHANES datasets with a Mendelian Randomization (MR) approach utilizing GWAS datasets. The MR analysis provides a level of evidence second only to randomized controlled trials, surpassing that of cohort and case-control studies.
Keywords
circulating immune cells, Mendelian randomization, National Health and Nutrition Examination Survey (NHANES), obstructive sleep apnea
Document Type
Journal Article
Date of Publication
7-1-2026
Article Number
101810
ISSN
18088694
Volume
92
Issue
4
PubMed ID
42224780
Publication Title
Brazilian Journal of Otorhinolaryngology
Publisher
Elsevier
School
Centre for Precision Health / School of Medical and Health Sciences
Funding Information
This project was supported by Beijing Natural Science Foundation (L243032), National Natural Science Foundation of China (81970866), and Innovative Health Promotion Strategies for China's New Era (2019-XZ-29).
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Jia, Y., Gao, X., Xu, S., Shi, J., Hou, H., Li, Y., & Han, D. (2026). Effects of obstructive sleep apnea on circulating immune cells profiles: Evidence from NHANES dataset and Mendelian randomization. Brazilian Journal of Otorhinolaryngology, 92(4), 101810. https://doi.org/10.1016/j.bjorl.2026.101810