Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Key Laboratory of Nephropathy, Hangzhou, Zhejiang, China.
J Cell Biochem. 2019 Sep;120(9):15766-15775. doi: 10.1002/jcb.28846. Epub 2019 May 8.
Hyperphosphatemia, hypocalcemia, and elevation of parathyroid hormone (PTH) are typical abnormalities of uremic patients with Secondary hyperparathyroidism (SHPT). However, metabolic imbalance associated with SHPT is not well understood.
A total of 15 SHPT patients with an intact parathyroid hormone (iPTH) level > 600 pg/mL were set as preoperative (PR) group, 15 age- and gender-matched controls who had undergone parathyroidectomy plus forearm transplantation because of hyperparathyroidism and achieved an iPTH level <150 pg/mL were set as postoperative (PO) group. Metabolite profiling of these 30 uremic patients and five healthy controls (HC) was performed using ultra performance liquid chromatography-mass spectrometry.
Five differential metabolites, including allyl isothiocyanate, L-phenylalanine, D-Aspartic acid, indoleacetaldehyde, and D-galactose correlated with PTH were identified in this study. Taking them as a biomarker signature, PR group can be distinguished from HC group with an area under the curve (AUC) of 0.947 (95% CI, 0.76-1) and PO group with an AUC of 0.6 (95% CI, 0.38-0.807).
The serum metabolome correlated with PTH is successfully demonstrated for a better understanding of the pathogenesis of SHPT.
高磷血症、低钙血症和甲状旁腺激素（PTH）升高是继发性甲状旁腺功能亢进症（SHPT）尿毒症患者的典型异常。然而，与 SHPT 相关的代谢失衡尚不清楚。
共纳入 15 例甲状旁腺激素（iPTH）水平>600pg/ml 的 SHPT 患者作为术前（PR）组，选择 15 例因甲状旁腺功能亢进接受甲状旁腺切除术和前臂移植且 iPTH 水平<150pg/ml 的年龄和性别匹配的患者作为术后（PO）组。采用超高效液相色谱-质谱联用技术对 30 例尿毒症患者和 5 例健康对照者（HC）的代谢物进行分析。
本研究共鉴定出 5 种与 PTH 相关的差异代谢物，包括丙烯基异硫氰酸酯、L-苯丙氨酸、D-天冬氨酸、吲哚乙醛和 D-半乳糖。以这些差异代谢物作为生物标志物特征，PR 组与 HC 组的曲线下面积（AUC）为 0.947（95%可信区间，0.76-1），PR 组与 PO 组的 AUC 为 0.6（95%可信区间，0.38-0.807）。
本研究成功证明了与 PTH 相关的血清代谢组学，有助于更好地理解 SHPT 的发病机制。
