Plasma metabolomics identifies obstructive sleep apnoea hypopnoea syndrome (OSAHS)

Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS) is associated with adverse cardiovascular risk and an inflammatory metabolic state. We applied untargeted metabolomic profiling on plasma obtained from consecutive attenders referred for conventional Level 3 home-sleep studies. We compared 17 OSAHS patients (AHI≥15) with 16 Sleepy Snorers (SS) (AHI<15).

Plasma samples were assessed by using the Q Exactive Hybrid Quadrupole-Orbitrap platform. Partial Least Squares – Discriminant Analysis (Fig. 1A) discriminated between the OSAHS and SS samples. Using analysis of variance corrected for false discovery rate, we identified 6 metabolites that together distinguished OSAHS from SS with an AUC value of 0.982 (95% CI: 0.9-1.0) (Fig. 1).

The key metabolites were gangliosides and lipids some of which are involved with e.g. histidine and inositol phosphate metabolism that are indicators of oxidative stress, inflammation and dysregulation of energy homeostasis. We report biologically plausible plasma biomarkers that can distinguish OSAHS from sleepy patients of similar phenotype with high accuracy. Further validation and changes with treatment are ongoing.