Prospective analyses of volatile organic compounds in obstructive sleep apnea patients

• DOI: 10.1093/toxsci/kfw260
• Publication Date: 2016-12-13T12:06:52Z
• Authors: Takuya Aoki; Takashi Nagaoka; Naofumi Kobayashi; Muneshige Kurahashi; Chizuko Tsuji; Hiroto Takiguchi; Katsuyoshi Tomomatsu; Tsuyoshi Oguma; Naoki Kobayashi; Kazushige Magatani; Sunao Takeda; Koichiro Asano; Tadashi Abe
• Keywords: Male; 0301 basic medicine; Sleep Apnea, Obstructive; Volatile Organic Compounds; Continuous Positive Airway Pressure; Polysomnography; Middle Aged; Severity of Illness Index; Gas Chromatography-Mass Spectrometry; 3. Good health; 03 medical and health sciences; Exhalation; Case-Control Studies; 11. Sustainability; Humans; Regression Analysis; Prospective Studies

Various volatile organic compounds (VOCs) are known to be toxic. Although exhaled VOC patterns change in obstructive sleep apnea (OSA) patients, individual VOC profiles are not fully determined. The primary outcome was VOC characterizations; secondary outcomes included their relationships with sleep and clinical parameters in OSA patients. We prospectively examined 32 OSA patients with an apnea-hypopnea index (AHI) ≥ 15 by full polysomnography, and 33 age- and sex-matched controls without obvious OSA symptoms. Nine severe OSA patients were examined before and after continuous positive airway pressure (CPAP) treatment. By applying a method which eliminates environmental VOC influences, exhaled VOCs were identified by gas chromatography (GC)-mass spectrometry, and their concentrations were determined by GC. Exhaled aromatic hydrocarbon concentrations (toluene, ethylbenzene, p-xylene, and phenylacetic acid) in the severe OSA groups (AHI ≥ 30) and exhaled saturated hydrocarbon concentrations (hexane, heptane, octane, nonane, and decane) in the most severe OSA group (AHI ≥ 60) were higher than those in the control group. Exhaled isoprene concentrations were increased in all OSA groups (AHI ≥ 15); acetone concentration was increased in the most severe OSA group. Ethylbenzene, p-xylene, phenylacetic acid, and nonane concentrations were increased according to OSA severity, and correlated with AHI, arousal index, and duration of percutaneous oxygen saturation (SpO2) ≤ 90%. Multiple regression analyses revealed these 4 VOC levels were associated with the duration of SpO2 ≤ 90%. Isoprene and acetone decreased after CPAP treatment. OSA increased some toxic VOCs, and some correlated with OSA severity. CPAP treatment possibly ameliorates these productions.