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. 2020 Sep 1;10(9):358.
doi: 10.3390/metabo10090358.

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

Abdulmohsen Alterki  1 , Shibu Joseph  2 , Thangavel Alphonse Thanaraj  3 , Irina Al-Khairi  4 , Preethi Cherian  4 , Arshad Channanath  3 , Devarajan Sriraman  2 , Mahmoud A K Ebrahim  1 , Alaaeldin Ibrahim  1 , Ali Tiss  4 , Fahd Al-Mulla  2 , Anas M Abdel Rahman  5   6   7 , Jehad Abubaker  4 , Mohamed Abu-Farha  4
Affiliations

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

Abdulmohsen Alterki et al. Metabolites. .

Abstract

Background: Obstructive sleep apnea (OSA) is caused by partial or complete obstruction of the upper airways. Corrective surgeries aim at removing obstructions in the nasopharynx, oropharynx, and hypopharynx. OSA is associated with an increased risk of various metabolic diseases. Our objective was to evaluate the effect of surgery on the plasma metabolome.

Methods: This study included 39 OSA patients who underwent Multilevel Sleep Surgery (MLS). Clinical and anthropometric measures were taken at baseline and five months after surgery.

Results: The mean Apnea-Hypopnea Index (AHI) significantly dropped from 22.0 ± 18.5 events/hour to 8.97 ± 9.57 events/hour (p-Value < 0.001). Epworth's sleepiness Score (ESS) dropped from 12.8 ± 6.23 to 2.95 ± 2.40 (p-Value < 0.001), indicating the success of the surgery in treating OSA. Plasma levels of metabolites, phosphocholines (PC) PC.41.5, PC.42.3, ceremide (Cer) Cer.44.0, and triglyceride (TG) TG.53.6, TG.55.6 and TG.56.8 were decreased (p-Value < 0.05), whereas lysophosphatidylcholines (LPC) 20.0 and PC.39.3 were increased (p-Value < 0.05) after surgery.

Conclusion: This study highlights the success of MLS in treating OSA. Treatment of OSA resulted in an improvement of the metabolic status that was characterized by decreased TG, PCs, and Cer metabolites after surgery, indicating that the success of the surgery positively impacted the metabolic status of these patients.

Keywords: apnea hypopnea index; ceramides; lipid metabolism; metabolomics; multilevel sleep surgery; obstructive sleep apnea; phosphocholines; polysomnography; triglycerides.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Polysomnographic data showing (A) the AHI score and (B) the ESS score, before and after the surgery. OSA was diagnosed based on an AHI >5 events/hour.
Figure 2
Figure 2
(A) volcano plot and (B) OPLSDA.
Figure 3
Figure 3
(A–C) Differentially expressed TGs before and after surgery, as measured by LC-MS using the biocrates P400 kit.
Figure 4
Figure 4
(A–C) Differentially expressed PCs and (D) LPC before and after surgery, as measured by LC-MS using the biocrates P400 kit.
Figure 5
Figure 5
Differentially expressed Ceramides before and after surgery, as measured by LC-MS using the biocrates P400 kit.
Figure 6
Figure 6
The area-under-the-curve (AUC) of Receiver Operating Characteristic (ROC) analysis showing Cer440 and PC423 specificity and selectivity to distinguish between the study groups.
See this image and copyright information in PMC

References

    1. Levy P., Kohler M., McNicholas W.T., Barbe F., McEvoy R.D., Somers V.K., Lavie L., Pepin J.L. Obstructive sleep apnoea syndrome. Nat. Rev. Dis. Primers. 2015;1:15015. doi: 10.1038/nrdp.2015.15. - DOI - PubMed
    1. Basoglu O.K., Tasbakan M.S. Elevated risk of sleepiness-related motor vehicle accidents in patients with obstructive sleep apnea syndrome: A case-control study. Traffic Inj. Prev. 2014;15:470–476. doi: 10.1080/15389588.2013.830213. - DOI - PubMed
    1. Jurado-Gamez B., Guglielmi O., Gude F., Buela-Casal G. Workplace accidents, absenteeism and productivity in patients with sleep apnea. Arch. Bronconeumol. 2015;51:213–218. doi: 10.1016/j.arbr.2014.12.002. - DOI - PubMed
    1. Saunders K.H., Igel L.I., Tchang B.G. Surgical and Nonsurgical Weight Loss for Patients with Obstructive Sleep Apnea. Otolaryngol. Clin. N. Am. 2020;53:409–420. doi: 10.1016/j.otc.2020.02.003. - DOI - PubMed
    1. Gottlieb D.J., Punjabi N.M. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA. 2020;323:1389–1400. doi: 10.1001/jama.2020.3514. - DOI - PubMed

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