Department of Epidemiology and Biostatistics, Global Health Sciences and the Preterm Birth Initiative, University of California San Francisco, San Francisco, California, USA.
Department of Public Health, Brown University, Providence, Rhode Island, USA.
Clin Transl Sci. 2019 Jan;12(1):28-38. doi: 10.1111/cts.12590. Epub 2018 Oct 28.
Our objective was to assess the relationship between hyperbilirubinemia with and without kernicterus and metabolic profile at newborn screening. Included were 1,693,658 infants divided into a training or testing subset in a ratio of 3:1. Forty-two metabolites were analyzed using logistic regression (odds ratios (ORs), area under the receiver operating characteristic curve (AUC), 95% confidence intervals (CIs)). Several metabolite patterns remained consistent across gestational age groups for hyperbilirubinemia without kernicterus. Thyroid stimulating hormone (TSH) and C-18:2 were decreased, whereas tyrosine and C-3 were increased in infants across groupings. Increased C-3 was also observed for kernicterus (OR: 3.17; 95% CI: 1.18-8.53). Thirty-one metabolites were associated with hyperbilirubinemia without kernicterus in the training set. Phenylalanine (OR: 1.91; 95% CI: 1.85-1.97), ornithine (OR: 0.76; 95% 0.74-0.77), and isoleucine + leucine (OR: 0.63; 95% CI: 0.61-0.65) were the most strongly associated. This study showed that newborn metabolic function is associated with hyperbilirubinemia with and without kernicterus.
我们的目的是评估伴有和不伴有核黄疸的高胆红素血症与代谢谱之间的关系。研究纳入了 1693658 名婴儿，按照 3:1 的比例分为训练或测试子集。使用逻辑回归（比值比（ORs），接受者操作特征曲线下的面积（AUC），95%置信区间（CIs））分析了 42 种代谢物。对于无核黄疸的高胆红素血症，几种代谢物模式在不同胎龄组中保持一致。甲状腺刺激激素（TSH）和 C-18:2 降低，而酪氨酸和 C-3 在各组婴儿中增加。核黄疸患儿的 C-3 也增加（OR：3.17；95%CI：1.18-8.53）。在训练集中，有 31 种代谢物与无核黄疸的高胆红素血症相关。苯丙氨酸（OR：1.91；95%CI：1.85-1.97）、鸟氨酸（OR：0.76；95%CI：0.74-0.77）和异亮氨酸+亮氨酸（OR：0.63；95%CI：0.61-0.65）与高胆红素血症的相关性最强。本研究表明新生儿代谢功能与伴有和不伴有核黄疸的高胆红素血症有关。
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