Metabolomics Analysis on Obesity-Related Obstructive Sleep Apnea After Weight Loss Management: A Preliminary Study

Abstract

ObjectiveRoux-en-Y gastric bypass (RYGB) surgery is an effective type of weight loss management and may improve obesity-related obstructive sleep apnea (OSA). Obese subjects who meet the criteria for surgery with OSA were enrolled. We investigated the metabolomic effects of RYGB on OSA.MethodsClinical data, serum measurements including indices of glycolipid metabolism, and polysomnography (PSG) measurements were collected at baseline and 6 months after RYGB surgery. Metabolomic analysis was performed using ultra-performance liquid chromatography-mass spectrometry.ResultsA group of 37 patients with obesity, type 2 diabetes (T2DM) and suspected OSA were enrolled of which 27 were OSA subjects. After RYGB surgery, metabolic outcomes and sleep parameters were all significantly improved. The OSA remission group had lower valine, isoleucine, and C24:1(cis-15) levels, and higher trimethylamine N-oxide, hippurate, and indole-3-propionic acid levels after RYGB surgery. A combination of preoperative indices (age, apnea-hypopnea index (AHI), fasting C-peptide level, and hippurate level) predicted the RYGB effect size in obese patients with T2DM and OSA, with an area under receiver operating characteristic curve of 0.947, specificity of 82.4%, and sensitivity of 100%.ConclusionsRYGB surgery may significantly improve the metabolic status of patients with obesity, T2DM and OSA. A combination of preoperative indices (age, AHI, fasting C peptide level, and hippurate level) may be useful for predicting the effect size of RYGB in obese patients with T2DM and OSA. The mechanisms underlying OSA remission need to be explored.

Metabolomics analysis of stool in rats with type 2 diabetes mellitus after single-anastomosis duodenal–ileal bypass with sleeve gastrectomy

“…Results of the current study showed that the level of proline was significantly lower in the sham operation group as compared with the SADI-S group. Elsewhere, it has been evident that the level of alanine is elevated after RYGB ( 41 ). Similarly, an elevated alanine levels after SADI-S was also found in the present study.…”

“…An elevated level of glycine causes an increase in level of hippuric acid and a decrease in level of the branched-chain amino acid, which contribute to the restoration of the mitochondrial function. A previous study has shown that increased level of hippuric acid is accompanied by a decrease in the levels of branched-chain amino acids after Roux-en-Y gastric bypass ( 41 ). The present study also showed that the remission of diabetes after SADI-S was accompanied by an elevation in the level of hippuric acid and a decline in the level of branched-chain amino acid.…”

A Scientometric Review of Obstructive Sleep Apnea and Obesity

“…Across the globe, obesity rates have doubled since 1980 [21], and recently, the United States of America has reported that the prevalence of obesity in adults was 41.9% [22]. Obesity has been established in many studies as one of the strongest risk factors of OSA [3,8,10,[23][24][25]. For example, there is evidence from a follow-up of the Wisconsin Sleep Cohort Study demonstrating that a 10% change in body weight is associated with an accompanying increase in approximately 30% in the AHI [24].…”