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

Abdulmohsen Alterki; Shibu Joseph; Thangavel Alphonse Thanaraj; Irina Al-Khairi; Preethi Cherian; Arshad Channanath; Devarajan Sriraman; Mahmoud A K Ebrahim; Alaaeldin Ibrahim; Ali Tiss; Fahd Al-Mulla; Anas M Abdel Rahman; Jehad Abubaker; Mohamed Abu-Farha

doi:10.3390/metabo10090358

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

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

Authors

Affiliations

¹ Department of Otolaryngology Head & Neck Surgery, Zain and Al Sabah Hospitals and Dasman Diabetes Institute, Dasman 15462, Kuwait.
² Special Service Facility Department, Dasman Diabetes Institute, Dasman 15462, Kuwait.
³ Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait.
⁴ Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman 15462, Kuwait.
⁵ Department of Genetics, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, Riyadh 11211, Saudi Arabia.
⁶ Department of Biochemistry and Molecular Medicine, College of Medicine, Al Faisal University, Riyadh 11533, Saudi Arabia.
⁷ Department of Chemistry, Memorial University of Newfoundland, St. John's, NL A1B 3X7, Canada.

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.