Dados do Trabalho

Título

DIAGNOSTIC ABILITY OF INSOMNIA THROUGH METABOLOMIC ANALYSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Introdução

Metabolomics has wide clinical applicability, constituting a powerful tool for evaluating metabolic variations in individuals with insomnia.

Objetivo

To evaluate the diagnostic ability of metabolomic analysis to detect insomnia in adults.

Métodos

Articles were searched for using the MEDLINE/PubMed, Cochrane, and VHL electronic databases by combining the Medical Subject Headings (MeSH) descriptors, including publications in English: Metabolomic, insomnia, adults. Inclusion criteria: articles that included metabolomic analysis, patients aged 18 years or older, diagnosed with insomnia by the Insomnia Severity Index (ISI), sleep diary, or the American Academy of Sleep Medicine criteria. Exclusion criteria: comorbidities, pregnant or breastfeeding women in the last 6 months, abstracts, conference proceedings, meetings and symposia, and crossover studies. PROSPERO registration number: CRD42021221679.

Resultados

A total of 791 studies were evaluated. Of these, 5 were included in the systematic review. Samples ranged from 30 to 40 subjects (total n = 167). One study identified 20 elevated and 14 reduced metabolites in patients with insomnia. The data obtained for glutamate/glutamine (Glx) levels were increased in insomniacs, while phosphocreatine (PCr) in the gray matter and phosphocholine in the white matter were reduced in this group. In addition, the GABA values were interesting since one study found it to be 30% reduced in insomniacs compared to the control group. Meanwhile, another study found this metabolite to be 12% higher in the occipital region in insomniacs.

Conclusões

Through the present study, it was possible to observe that many metabolites were able to characterize individuals with insomnia, especially the reduction of GABA at the brain level, phosphocreatine in the gray matter, and phosphocholine in the white matter. Despite the potential of some metabolic markers in predicting insomnia in adults, further studies will be necessary, with the definition of targeted algorithms and allowing the discussion of an eventual consensus for their practical application.

Palavras -chave

Adult. Sleep Initiation and Maintenance Disorders. Metabolomics.