Deng Dazhi, Liu Ling, Xu Guangma, Gan Jianting, Shen Yin, Shi Ying, Zhu Ruikai, Lin Yingzhong
Dept. of Emergency, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Province, 530021, China.
Dept. of Cardiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Province, 530021, China.
Iran J Public Health. 2018 Jul;47(7):1017-1029.
We aimed to find a potential earlier diagnostic strategy for acute myocardial infarction (AMI) by investigating the epidemiology and serum metabolic characteristics of AMI patients in comparison with those of chest pain controls (CPCS).
We conducted this prospective, non-randomized, observational study of patients with acute chest pain symptoms presenting to the Emergency Rooms (ER) in The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Province, China from January 2015 to July 2016. We included a cohort of 45 patients with AMI together with 45 age- and sex-matched CPCS. The epidemiology of AMI was collected, and the phenotypic characteristics of the serum metabolite composition of AMI patients were determined using a combination of 1H nuclear magnetic resonance (NMR)-based metabolomics and clinical assays.
The epidemiology showed that elderly AMI patients with chest pain syndrome presenting to ER have little awareness of their physical condition and compliance with medication. Significant serum metabolic differences observed between AMI patients and CPCS were highlighted by system differentiations in multiple metabolic pathways including anaerobic glycolysis, gluconeogenesis, tricarboxylic acid cycle (TCA cycle), protein biosynthesis, lipoprotein changes, choline and fatty acid metabolisms and intestinal microbial metabolism.
The epidemiology and serum metabolic phenotypes observed here demonstrated that integration of metabolomics with other techniques could be useful for better understanding the biochemistry of AMI and for potential AMI molecular diagnosis. We should improve the general public's awareness of AMI, including early symptoms, risk factors, emergency responses, and treatments for related comorbidities.
我们旨在通过调查急性心肌梗死（AMI）患者与胸痛对照者（CPCS）的流行病学和血清代谢特征，寻找一种潜在的早期诊断急性心肌梗死的策略。
我们对2015年1月至2016年7月在中国广西壮族自治区南宁市广西壮族自治区人民医院急诊科就诊的急性胸痛症状患者进行了这项前瞻性、非随机、观察性研究。我们纳入了45例急性心肌梗死患者以及45例年龄和性别匹配的胸痛对照者。收集急性心肌梗死的流行病学资料，并结合基于1H核磁共振（NMR）的代谢组学和临床检测方法，确定急性心肌梗死患者血清代谢物组成的表型特征。
流行病学研究表明，因胸痛综合征到急诊科就诊的老年急性心肌梗死患者对自身身体状况的认知度低，服药依从性差。急性心肌梗死患者与胸痛对照者之间观察到的显著血清代谢差异，在包括无氧糖酵解、糖异生、三羧酸循环（TCA循环）、蛋白质生物合成、脂蛋白变化、胆碱和脂肪酸代谢以及肠道微生物代谢在内的多个代谢途径的系统差异中得到凸显。
此处观察到的流行病学和血清代谢表型表明，将代谢组学与其他技术相结合，可能有助于更好地理解急性心肌梗死生物化学机制及进行潜在的急性心肌梗死分子诊断。我们应提高公众对急性心肌梗死的认识，包括早期症状、危险因素、应急反应以及相关合并症的治疗。
