Metabolipidomic Analysis in Patients with Obstructive Sleep Apnea Discloses a Circulating Metabotype of Non-Dipping Blood Pressure.
Lucía PinillaIván David BenítezEsther Gracia-LavedanGerard TorresOlga MínguezRafaela VacaMariona JovéJoaquim SolReinald PamplonaFerran BarbéManuel Sánchez-de-la-TorrePublished in: Antioxidants (Basel, Switzerland) (2023)
A non-dipping blood pressure (BP) pattern, which is frequently present in patients with obstructive sleep apnea (OSA), confers high cardiovascular risk. The mechanisms connecting these two conditions remain unclear. In the present study we performed a comprehensive analysis of the blood metabolipidome that aims to provide new insights into the molecular link between OSA and the dysregulation of circadian BP rhythmicity. This was an observational prospective longitudinal study involving adults with suspected OSA who were subjected to full polysomnography (PSG). Patients with an apnea-hypopnea index ≥ 5 events/h were included. Fasting plasma samples were obtained the morning after PSG. Based on the dipping ratio (DR; ratio of night/day BP values) measured via 24 h ambulatory BP monitoring, two groups were established: dippers (DR ≤ 0.9) and non-dippers (DR > 0.9). Treatment recommendations for OSA followed the clinical guidelines. Untargeted metabolomic and lipidomic analyses were performed in plasma samples via liquid chromatography-tandem mass spectrometry. Non-dipper patients represented 53.7% of the cohort (88/164 patients). A set of 31 metabolic species and 13 lipidic species were differentially detected between OSA patients who present a physiologic nocturnal BP decrease and those with abnormal BP dipping. Among the 44 differentially abundant plasma compounds, 25 were putatively identified, notably glycerophospholipids, glycolipids, sterols, and fatty acid derivates. Multivariate analysis defined a specific metabotype of non-dipping BP, which showed a significant dose-response relationship with PSG parameters of OSA severity, and with BP dipping changes after 6 months of OSA treatment with continuous positive airway pressure (CPAP). Bioinformatic analyses revealed that the identified metabolipidomic profile was found to be implicated in multiple systemic biological pathways, with potential physiopathologic implications for the circadian control of BP among individuals with OSA.
Keyphrases
- obstructive sleep apnea
- positive airway pressure
- blood pressure
- sleep apnea
- end stage renal disease
- liquid chromatography tandem mass spectrometry
- chronic kidney disease
- ejection fraction
- fatty acid
- clinical practice
- mass spectrometry
- prognostic factors
- pulmonary embolism
- peritoneal dialysis
- depressive symptoms
- adipose tissue
- climate change
- editorial comment
- metabolic syndrome
- patient reported outcomes
- simultaneous determination
- cross sectional
- combination therapy