基于血清代谢组学的阻塞性睡眠呼吸暂停中医证型代谢模式差异分析OA

Objective Obstructive sleep apnea(OSA)is a common sleep-related breathing disorder.The theory of"dysfunction of qi transformation in the triple-energizer"in traditional Chinese medicine(TCM)is one kind of important theory for elucidating its pathogenesis.However,the modern biological basis of this theory,particularly its molecular-level interpretation,remains insufficiently explored.This study aims to reveal the differential metabolic patterns associated with different TCM syndrome types in OSA using serum metabolomics,thereby providing a scientific basis for the"dysfunction of qi transformation in the triple-energizer"theory from a molecular perspective.Methods A total of 57 OSA patients(22 with lung-spleen deficiency syndrome,21 with phlegm-damp syndrome,and 14 with blood stasis syndrome)who visited the inpatient ward or outpatient clinic of the Department of Traditional Chinese Medicine at the First People's Hospital of Kashi Prefecture from June 2024 to May 2025 were recruited.Additionally,22 age-and gender-matched healthy volunteers from the Physical Examination Center of the same hospital during the same period were enrolled as the healthy control group.Serum samples were collected from all participants.Untargeted metabolomic profiling was performed using ultra-performance liquid chromatography-mass spectrometry(UPLC-MS).Orthogonal partial least squares discriminant analysis(OPLS-DA)was employed to screen for differential metabolites between groups.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic efficacy of potential biomarkers.Metabolic pathway enrichment analysis was conducted for the identified differential metabolites.Results OPLS-DA models clearly distinguished each OSA syndrome type group from the healthy control group.A substantial number of differential metabolites were identified.Compared with the healthy control group,241,189,and 61 significantly differential metabolites were screened in the lung-spleen deficiency syndrome,phlegm-damp syndrome,and blood stasis syndrome groups,respectively.Each syndrome type possessed characteristic combinations of potential biomarkers.Metabolic pathway analysis revealed that differential metabolites in the lung-spleen deficiency syndrome were primarily enriched in glutathione metabolism and the FoxO signaling pathway.Differential metabolites in the phlegm-damp syndrome were mainly enriched in purine metabolism and alanine,aspartate,and glutamate metabolism.Differential metabolites in the blood stasis syndrome were predominantly enriched in tyrosine metabolism and ascorbate and aldarate metabolism.Conclusion This study systematically reveals,for the first time from a metabolomic perspective,the existence of specific metabolic disorder profiles associated with different TCM syndrome types of OSA.The results provide molecular-level evidence intuitively corroborating the scientific connotation of OSA pathogenesis evolving along the"dysfunction of qi transformation in the triple-energizer"theory,and its transitions from"upper-and middle-energizer dysfunction"to"collateral stasis obstruction".