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The different roles of homocysteine metabolism in hypertension among normal-weight and obese patients with obstructive sleep apnea.
Chen, Baixin; Chen, Le; Dai, Yanyuan; Wu, Jun; Zheng, Dandan; Vgontzas, Alexandros N; Tang, Xiangdong; Li, Yun.
Afiliação
  • Chen B; Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of University of Manitoba
  • Chen L; Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of University of Manitoba
  • Dai Y; Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of University of Manitoba
  • Wu J; Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of University of Manitoba
  • Zheng D; Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of University of Manitoba
  • Vgontzas AN; Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
  • Tang X; Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
  • Li Y; Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, Guangdong, China; Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China; Shantou University Medical College-Faculty of Medicine of University of Manitoba
Sleep Med ; 120: 1-9, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38824846
ABSTRACT

BACKGROUND:

Obstructive sleep apnea (OSA) is associated with hypertension. However, the differential mechanisms underlying OSA-related hypertension between normal-weight vs. obese patients is limited.

METHODS:

We studied 92 patients with OSA and 24 patients with continuous positive airway pressure (CPAP) treatment. Blood pressure (BP) was measured twice during awake and continuously monitored during sleep. Obesity was defined as body mass index ≥28 kg/m2. Serum metabolite levels were assessed by metabolomics.

RESULTS:

Among 59 normal-weight and 33 obese patients, 651 and 167 metabolites showed differences between hypertension and normotension or were associated with systolic and diastolic BP (SBP, DBP) after controlling confounders. These metabolites involved 16 and 12 Kyoto Encyclopedia of Genes and Genomes enrichment pathways in normal-weight and obese patients respectively, whereas 6 pathways overlapped. Among these 6 overlapping pathways, 4 were related to homocysteine metabolism and 2 were non-specific pathways. In homocysteine metabolism pathway, 13 metabolites were identified. Interestingly, the change trends of 7 metabolites associated with SBP (all interaction-p≤0.083) and 8 metabolites associated with DBP (all interaction-p≤0.033) were opposite between normal-weight and obese patients. Specifically, increased BP was associated with down-regulated folate-dependent remethylation and accelerated transsulfuration in normal-weight patients, whereas associated with enhanced betaine-dependent remethylation and reduced transsulfuration in obese patients. Similar findings were observed in ambulatory BP during sleep. After CPAP treatment, baseline low homocysteine levels predicted greater decrease in DBP among normal-weight but not obese patients.

CONCLUSIONS:

Mechanisms in OSA-related hypertension differ between normal-weight and obese patients, which are explained by different changes in homocysteine metabolism.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apneia Obstrutiva do Sono / Pressão Positiva Contínua nas Vias Aéreas / Homocisteína / Hipertensão / Obesidade Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Sleep Med Assunto da revista: NEUROLOGIA / PSICOFISIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apneia Obstrutiva do Sono / Pressão Positiva Contínua nas Vias Aéreas / Homocisteína / Hipertensão / Obesidade Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Sleep Med Assunto da revista: NEUROLOGIA / PSICOFISIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Holanda