Metabolomic and lipidomic profile in men with obstructive sleep apnoea: implications for diagnosis and biomarkers of cardiovascular risk

Abstract

The use of metabolomic and lipidomic strategies for selecting potential biomarkers for obstructive sleep apnoea (OSA) has been little explored. We examined adult male patients with OSA (defined by an apnoea-hypopnoea index ≥15 events/hour), as well as age-, gender-, and fat-composition-matched volunteers without OSA. All subjects were subjected to clinical evaluation, sleep questionnaires for detecting the risk of OSA (Berlin and NoSAS score), metabolomic analysis by gas chromatography coupled to mass spectrometry and lipidomic analysis with liquid chromatography followed by detection by MALDI-MS. This study included 37 patients with OSA and 16 controls. From the 6 metabolites and 22 lipids initially selected, those with the best association with OSA were glutamic acid, deoxy sugar and arachidonic acid (metabolites), and glycerophosphoethanolamines, sphingomyelin and lyso-phosphocholines (lipids). For the questionnaires, the NoSAS score performed best with screening for OSA (area under the curve [AUC] = 0.724, p = 0.003). The combination of the NoSAS score with metabolites or lipids resulted in an AUC for detecting OSA of 0.911 and 0.951, respectively. In conclusion, metabolomic and lipidomic strategies suggested potential early biomarkers in OSA that could also be helpful in screening for this sleep disorder beyond traditional questionnaires.

Targeted Metabolomics Analysis on Obstructive Sleep Apnea Patients after Multilevel Sleep Surgery

“…They were also linked to promoting fatty acid-induced insulin resistance. In line with our data, Lebkuchen et al showed that species of LPC were upregulated by OSA [ 59 ]. This finding could possibly show a different pattern of expression of LPCs or could be due to one of the main limitations of this study, which is the limited number of participants dictated by the nature of our study, which involved surgical intervention.…”

“…Interestingly, two PCs were increased following the surgical treatment of OSA. Previously, Lebkuchen et al showed that people with OSA had a reduction in PCs [ 59 ]. They linked the observed reduction in PCs to the increased damaging activity of various phospholipase A1 (PLA1), A2 (PLA2), and C (PLC), which are activated under hypoxic conditions.…”

Adipose tissue as a key player in obstructive sleep apnoea

“…To better define the appropriate treatment for a single patient, we need combinations of biomarkers that are able to characterise IH consequences at the level of the different metabolic organs. Metabolomic and lipidomic profiles in OSA have been reported as distinct from a control group matched for age, BMI and body composition [70]. Also, in a relatively large sample of nonobese and obese OSA, we recently found an independent correlation of OSA severity with the M1 macrophage inflammatory marker sCD163 [23].…”

Metabolomics in Sleep, Insomnia and Sleep Apnea

“…Overall, metabolites related to lipid-metabolism represented a significant fraction of reported biomarkers, comprising mainly lipids or related biomarkers. Those biomarkers included phospholipids (phosphatidylcholines, posphatidylserines, lysophosphatidylcholines, lysophosphatidic acid, phosphatidylethanolamine, sphingomyelins) [ 41 , 56 ] and circulating endocannabinoids [ 57 ]. Furthermore, differences in urine metabolome were observed, including changes in acylcarnitines, glycerophospholipids and sphingomyelins [ 58 ].…”