Salles Cristina, Freitas Maria Clara, Souza Amancio, Ribeiro Paulo, Dias Cristiane, Rosa Michele, Meira E Cruz Miguel
International Center on Clinical Sleep Medicine and Research, Bahiana School of Medicine and Public Health, Salvador, Brazil.
Public Health Sciences, University of California, San Diego, USA.
Sleep Biol Rhythms. 2023 Feb 8;21(3):265-277. doi: 10.1007/s41105-023-00445-5. eCollection 2023 Jul.
Obstructive Sleep Apnea (OSA) corresponds to episodes of complete or partial upper airway obstruction during sleep. The gold standard for diagnosing OSA is polysomnography; however, metabolomics is an innovative and highly sensitive method that seeks to identify and quantify small molecules in biological systems. Identify the metabolites most frequently associated with obstructive sleep apnea in adults. The search for articles was conducted between October 2020 and August 2021, in electronic databases, such as MEDLINE/PubMed, Scielo, Embase, and Cochrane, through the combination of descriptors: obstructive sleep apnea, metabolomic, adult. This systematic review included all cross-sectional studies published, including human patients aged 18 years or older, of both genders who underwent type I or II polysomnography and metabolomics study. The search strategy selected 3697 surveys, and 4 of them were selected to be a part of this systematic review. Based on the analyzed surveys, it was found that all of them were able to diagnose OSA, reaching a sensitivity of 75-97%, and specificity that ranged from 72 to 100%; besides differentiating patients with OSA (severe, moderate, and mild) from simple snorers with a mean sensitivity of 77.2% and specificity of 66.25%. These findings suggest that, in addition to being used as a screening and diagnostic strategy for OSA, metabolomics has the potential to be used for severity stratification and to monitor the disease's progression.
阻塞性睡眠呼吸暂停（OSA）是指睡眠期间上呼吸道完全或部分阻塞的发作。诊断OSA的金标准是多导睡眠图；然而，代谢组学是一种创新且高度灵敏的方法，旨在识别和量化生物系统中的小分子。确定成人中与阻塞性睡眠呼吸暂停最常相关的代谢物。于2020年10月至2021年8月期间在电子数据库（如MEDLINE/PubMed、Scielo、Embase和Cochrane）中进行文献检索，检索词组合为：阻塞性睡眠呼吸暂停、代谢组学、成人。本系统评价纳入了所有已发表的横断面研究，包括年龄在18岁及以上、接受I型或II型多导睡眠图和代谢组学研究的成年男女患者。检索策略筛选出3697项研究，其中4项被选入本系统评价。基于分析的研究发现，所有这些研究均能够诊断OSA，灵敏度达到75%-97%，特异性范围为72%-100%；此外，还能将OSA患者（重度、中度和轻度）与单纯打鼾者区分开来，平均灵敏度为77.2%，特异性为66.25%。这些发现表明，代谢组学除了可作为OSA的筛查和诊断策略外，还具有用于严重程度分层和监测疾病进展的潜力。
