Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea

Abstract Hypoxia is a contributing factor for the morbidity and mortality in patients with obstructive sleep apnea (OSA). We aimed at identifying the percentage of sleep time with oxyhemoglobin desaturation below 90% (Tc90%) breakpoint from which the most significant changes occur in systemic metabo...

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Main Authors: Ott Kiens, Egon Taalberg, Viktoria Ivanova, Ketlin Veeväli, Triin Laurits, Ragne Tamm, Aigar Ottas, Kalle Kilk, Ursel Soomets, Alan Altraja
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-96386-9
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author Ott Kiens
Egon Taalberg
Viktoria Ivanova
Ketlin Veeväli
Triin Laurits
Ragne Tamm
Aigar Ottas
Kalle Kilk
Ursel Soomets
Alan Altraja
author_facet Ott Kiens
Egon Taalberg
Viktoria Ivanova
Ketlin Veeväli
Triin Laurits
Ragne Tamm
Aigar Ottas
Kalle Kilk
Ursel Soomets
Alan Altraja
author_sort Ott Kiens
collection DOAJ
description Abstract Hypoxia is a contributing factor for the morbidity and mortality in patients with obstructive sleep apnea (OSA). We aimed at identifying the percentage of sleep time with oxyhemoglobin desaturation below 90% (Tc90%) breakpoint from which the most significant changes occur in systemic metabolome of patients with OSA. In a prospective observational study on patients with polysomnography–confirmed symptomatic OSA, profiles of 186 metabolites including amino acids, biogenic amines, acylcarnitines (AC), lysophosphatidylcholines, phosphatidylcholines (PC) and sphingomyelins (SM) were analyzed with liquid chromatography-mass-spectrometry in peripheral blood, obtained at 3 time points that covered patients’ night sleep. Comparisons of rank-transformed data with general linear model for repeated measures after dichotomizing the study group at different Tc90% levels were applied to define the best cut-off, hypoxic metabolic threshold (HMT), based on Cohen’s f. Fifty-one subjects were recruited with their median Tc90% of 2.1. The mean Cohen’s f over the metabolites was highest (0.165) at a Tc90% of 1.8 representing the HMT. Of the different classes of metabolites, the Cohen’s f value at HMT was highest for SM (0.322). Compared to patients with Tc90% < HMT, concentrations of 2 PC, 1 AC and 7 SM were significantly higher in patients with Tc90% ≥HMT. The HMT for patients with OSA described in this report for the first time is located at a Tc90% level of 1.8 with SM levels contributing most to the size of this threshold.
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spelling doaj-art-a67c41b1d2554a57831a03eb2cfe9ed62025-08-20T02:28:05ZengNature PortfolioScientific Reports2045-23222025-04-011511810.1038/s41598-025-96386-9Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apneaOtt Kiens0Egon Taalberg1Viktoria Ivanova2Ketlin Veeväli3Triin Laurits4Ragne Tamm5Aigar Ottas6Kalle Kilk7Ursel Soomets8Alan Altraja9Department of Pulmonary Medicine, University of TartuInstitute of Biomedicine and Translational Medicine, University of TartuLung Clinic, Tartu University HospitalPsychiatry Clinic, Tartu University HospitalPsychiatry Clinic, Tartu University HospitalPsychiatry Clinic, Tartu University HospitalInstitute of Biomedicine and Translational Medicine, University of TartuInstitute of Biomedicine and Translational Medicine, University of TartuInstitute of Biomedicine and Translational Medicine, University of TartuDepartment of Pulmonary Medicine, University of TartuAbstract Hypoxia is a contributing factor for the morbidity and mortality in patients with obstructive sleep apnea (OSA). We aimed at identifying the percentage of sleep time with oxyhemoglobin desaturation below 90% (Tc90%) breakpoint from which the most significant changes occur in systemic metabolome of patients with OSA. In a prospective observational study on patients with polysomnography–confirmed symptomatic OSA, profiles of 186 metabolites including amino acids, biogenic amines, acylcarnitines (AC), lysophosphatidylcholines, phosphatidylcholines (PC) and sphingomyelins (SM) were analyzed with liquid chromatography-mass-spectrometry in peripheral blood, obtained at 3 time points that covered patients’ night sleep. Comparisons of rank-transformed data with general linear model for repeated measures after dichotomizing the study group at different Tc90% levels were applied to define the best cut-off, hypoxic metabolic threshold (HMT), based on Cohen’s f. Fifty-one subjects were recruited with their median Tc90% of 2.1. The mean Cohen’s f over the metabolites was highest (0.165) at a Tc90% of 1.8 representing the HMT. Of the different classes of metabolites, the Cohen’s f value at HMT was highest for SM (0.322). Compared to patients with Tc90% < HMT, concentrations of 2 PC, 1 AC and 7 SM were significantly higher in patients with Tc90% ≥HMT. The HMT for patients with OSA described in this report for the first time is located at a Tc90% level of 1.8 with SM levels contributing most to the size of this threshold.https://doi.org/10.1038/s41598-025-96386-9MetabolomeMetabolismObstructive sleep apneaHypoxiaMetabolomic threshold
spellingShingle Ott Kiens
Egon Taalberg
Viktoria Ivanova
Ketlin Veeväli
Triin Laurits
Ragne Tamm
Aigar Ottas
Kalle Kilk
Ursel Soomets
Alan Altraja
Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea
Scientific Reports
Metabolome
Metabolism
Obstructive sleep apnea
Hypoxia
Metabolomic threshold
title Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea
title_full Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea
title_fullStr Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea
title_full_unstemmed Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea
title_short Serum sphingomyelin levels define oxyhemoglobin desaturation-related metabolic threshold in symptomatic obstructive sleep apnea
title_sort serum sphingomyelin levels define oxyhemoglobin desaturation related metabolic threshold in symptomatic obstructive sleep apnea
topic Metabolome
Metabolism
Obstructive sleep apnea
Hypoxia
Metabolomic threshold
url https://doi.org/10.1038/s41598-025-96386-9
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