Introduction: Obstructive sleep apnea (OSA) is a chronic, heterogeneous and multicomponent disorder with associated cardiovascular and metabolic alterations. Despite being the most common sleep-disordered breathing, it remains a significantly undiagnosed condition.
Objective: We examined the plasma metabolome and lipidome of patients with suspected OSA, aiming to identify potential diagnosis biomarkers and to provide insights into the pathophysiological mechanisms underlying the disease. Additionally, we evaluated the impact of continuous positive airway pressure (CPAP) treatment on the circulating metabolomic and lipidomic profile.
Material And Methods: Observational-prospective-longitudinal study including 206 consecutive subjects referred to the sleep unit. OSA was defined as an apnea-hypopnoea index ≥ 15 events/h after polysomnography (PSG). Patients treated with CPAP were followed-up for 6 months. Untargeted plasma metabolomic and lipidomic profiling was performed using liquid chromatography coulpled to massspectrometry.
Results: A plasma profile composed of 33 metabolites (mainly glycerophospholipids and bile acids) was identified in OSA vs. non-OSA patients. This profile correlated with specific PSG measures of OSA severity related to sleep fragmentation and hypoxemia. Machine learning analyses disclosed a 4-metabolites-signature that provided an accuracy (95% CI) of 0.98 (0.95-0.99) for OSA detection. CPAP treatment was associated with changes in 5 plasma metabolites previously altered by OSA.
Conclusions: This analysis of the circulating metabolome and lipidome reveals a molecular fingerprint of OSA, which was modulated after effective CPAP treatment. Our results suggest blood-based biomarker candidates with potential application in the personalized management of OSA and suggest the activation of adaptive mechanisms in response to OSA-derived hypoxia.
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http://dx.doi.org/10.1016/j.biopha.2021.112425 | DOI Listing |
Cureus
December 2024
Anesthesiology, University of Texas Medical Branch, Galveston, USA.
We report a case of a 39-year-old male patient who developed propofol-induced fasciculations during the induction of general anesthesia. The patient had a history of moderate obstructive sleep apnea and was intolerant to continuous positive airway pressure therapy. He subsequently underwent the insertion of a hypoglossal nerve stimulator as a viable surgical intervention.
View Article and Find Full Text PDFInt Arch Otorhinolaryngol
January 2025
Department of Chest Diseases, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Drug-induced sleep endoscopy (DISE) is performed widely, and several studies have demonstrated its validity as it provides clinical information not available by routine clinical inspection alone. This study aims to evaluate the role of transoral drug-induced sleep endoscopy (DISE) in the evaluation of tongue-palate (TP) interaction and its impact on surgical outcomes. A total of 42 patients with known obstructive sleep apnea syndrome (OSAS) were classified into two groups according to TP interaction (the absence of space between tongue and palate with the visual impression that the tongue is pushing the soft palate) into +ve and -ve TP interaction.
View Article and Find Full Text PDFBMJ Open
January 2025
Division of Neonatal Medicine, Department of Paediatrics and Child Health, University of Nairobi School of Medicine, Nairobi, Kenya.
Background: Respiratory Distress Syndrome (RDS) is the most common complication of preterm neonates. It remains one of the major public health concerns that contribute to neonatal mortality and morbidity, especially in Africa, where 80% of neonatal mortality is estimated to be caused by preterm complications. Nasal Continuous Positive Airway Pressure (NCPAP) ventilation is the preferred mode of RDS treatment.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Background: Continuous Positive Airway Pressure (CPAP) treatment brings more benefits than risks to most coronary heart disease (CHD) patients with obstructive sleep apnea (OSA). However, the pathophysiological mechanism by which CPAP treatment improves the prognosis of patients with CHD and OSA remains unclear. The purpose of this study was to clarify whether CPAP can improve arterial stiffness and inflammatory factor levels in CHD patients with OSA, and to further improve prognosis.
View Article and Find Full Text PDFIntern Med J
January 2025
Department of Respiratory Medicine, The Alfred Health, Melbourne, Victoria, Australia.
Background And Aims: Ward-delivered non-invasive respiratory supports (NIRS) (conventional oxygen therapy (COT), high-flow nasal oxygen (HFNO), continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV)), are often used to treat hospitalised patients with acute respiratory failure (ARF) both in high acuity and general wards. This study aimed to describe the processes of care adopted and examine patient outcomes from a specialist, ward-delivered NIRS service caring for people with COVID-19 in general wards or in a respiratory care unit (RCU).
Methods: A cohort study was undertaken including all consecutive patients admitted to a quaternary hospital with ARF secondary to COVID-19 and requiring ward-delivered NIRS between 28 February 2020 and 18 March 2022.
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