Issue Navigator

Volume 14 No. 09
Earn CME
Accepted Papers

Scientific Investigations

Pediatric Obstructive Sleep Apnea is Associated With Changes in the Oral Microbiome and Urinary Metabolomics Profile: A Pilot Study

Huajun Xu, MD, PhD1,2,3; Xiaoyan Li, MD4; Xiaojiao Zheng, PhD5; Yunyan Xia, MD1,2,3; Yiqun Fu, MD1,2,3; Xinyi Li, MD1,2,3; Yingjun Qian, MD, PhD1,2,3; Jianyin Zou, MD, PhD1,2,3; Aihua Zhao, PhD5; Jian Guan, MD, PhD1,2,3; Meizhen Gu, MD4; Hongliang Yi, MD, PhD1,2,3; Wei Jia, PhD5,6; Shankai Yin, MD, PhD1,2,3
1Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; 2Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China; 3Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 4Department of Otolaryngology-Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China; 5Center for Translational Medicine, and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; 6Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii

Study Objectives:

Several cross-sectional studies have reported associations between oral diseases and obstructive sleep apnea (OSA). However, there have been no reports regarding the structure and composition of the oral microbiota with simultaneous evaluation of potential associations with perturbed metabolic profiles in pediatric OSA.


An integrated approach, combining metagenomics based on high-throughput 16S rRNA gene sequencing, and metabolomics based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry and gas chromatography coupled with time-of-flight mass spectrometry, was used to evaluate the oral microbiome and the urinary metabolome.


16S rRNA gene sequencing indicated that the oral microbiome composition was significantly perturbed in pediatric OSA compared with normal controls, especially with regard to Firmicutes, Proteobacteria, Bacteroidetes, Fusobacteria, and Actinobacteria. Moreover, metabolomics profiling indicated that 57 metabolites, 5 of which were metabolites related to the microflora of the digestive tract, were differentially present in the urine of pediatric patients with OSA and controls. Co-inertia and correlation analyses revealed that several oral microbiome changes were correlated with urinary metabolite perturbations in pediatric OSA. However, this correlation relationship does not imply causality.


High-throughput sequencing revealed that the oral microbiome composition and function were significantly altered in pediatric OSA. Further studies are needed to confirm and determine the mechanisms underlying these findings.


Xu H, Li X, Zheng X, Xia Y, Fu Y, Li X, Qian Y, Zou J, Zhao A, Guan J, Gu M, Yi H, Jia W, Yin S. Pediatric obstructive sleep apnea is associated with changes in the oral microbiome and urinary metabolomics profile: a pilot study. J Clin Sleep Med. 2018;14(9):1559–1567.

Supplemental Material

Login to view supplemental material

Please login to continue reading the full article

Subscribers to JCSM get full access to current and past issues of the JCSM.

Login to JCSM

Not a subscriber?

Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership

Subscribe to JCSM:  $75/volume year for individuals or $140/volume year for institutions to access all current articles and archives published in JCSM.

Download this article*:   $20 to access a PDF version of a specific article from the current issue of JCSM.

*Purchase of an electronic download of JCSM provides permission to access and print the issue/article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.