Gut microbiota in obstructive sleep apnea–hypopnea syndrome: disease-related dysbiosis and metabolic comorbidities

Abstract

Gut microbiota alterations manifest as intermittent hypoxia and fragmented sleep, thereby mimicking obstructive sleep apnea–hypopnea syndrome (OSAHS). Here, we sought to perform the first direct survey of gut microbial dysbiosis over a range of apnea–hypopnea indices (AHI) among patients with OSAHS. We obtained fecal samples from 93 patients with OSAHS [5 < AHI ≤ 15 (n=40), 15 < AHI ≤ 30 (n=23), and AHI ≥ 30 (n=30)] and 20 controls (AHI ≤ 5) and determined the microbiome composition via 16S rRNA pyrosequencing and bioinformatics analysis of variable regions 3–4. We measured fasting levels of homocysteine (HCY), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). Results revealed gut microbial dysbiosis in several patients with varying severities of OSAHS, reliably separating them from controls with a receiver operating characteristic-area under the curve (ROC-AUC) of 0.789. Functional analysis in the microbiomes of patients revealed alterations; additionally, decreased in short-chain fatty acid (SCFA)-producing bacteria and increased pathogens, accompanied by elevated levels of IL-6. Lactobacillus levels correlated with HCY levels. Stratification analysis revealed that the Ruminococcus enterotype posed the highest risk for patients with OSAHS. Our results show that the presence of an altered microbiome is associated with HCY among OSAHS patients. These changes in the levels of SCFA affect the levels of pathogens that play a pathophysiological role in OSAHS and related metabolic comorbidities.

Gut microbial composition in patients with atrial fibrillation: effects of diet and drugs

“…A lower Prevotella-prominent enterotype in AF patients was obtained in both studies. The increase in the Ruminococcus-predominant enterotype is characteristic of AF patients, and similar results were obtained from studies of CAD [3], symptomatic atherosclerosis [33], and obstructive sleep apnea-hypopnea syndrome (OSAHS) [34]. Patients with atherosclerosis and OSAHS have risk factors similar to those of AF patients.…”

Gut microbiome diversity is associated with sleep physiology in humans

“…Our redundancy analysis revealed several taxa (genera and families) associated with measures of sleep (Fig 3). Previous work [68] examining the relationship between gut microbiome composition and severity of sleep apnea–hypopnea syndrome found that a decrease in the relative abundance of Sutterella and Brevibacterium generally coincided with an increase in severity of the disease state. In congruence with these previous findings, our study found that there was a negative correlation between these genera, and the number of awakenings.…”

Gut Microbiome Signatures Are Biomarkers for Cognitive Impairment in Patients With Ischemic Stroke

“…Previous studies also reported that Hcy levels were associated with increased risk of severe deep and periventricular white matter lesions, contributing to poor cognitive performance (Vermeer et al, 2002), and the strong associations between increased Hcy levels and cognitive decline in patients with AD and Parkinson's disease had been confirmed (Di Meco et al, 2018;Murray and Jadavji, 2019). Some researchers hypothesized that the Hcy/lipopolysaccharide (LPS) might mediate pyroptosis in the obese adipocytes due to the GM imbalance (Laha et al, 2018), and the altered microbiome in OSAHS patients was associated with Hcy (Ko et al, 2019). Besides, LA also contributed to cognitive deterioration by triggering the release of inflammatory factors (Kaffashian et al, 2016;Hainsworth et al, 2017).…”