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基于合并症和其他基础情况的脓毒性休克患者的血清代谢特征。

Serum metabolic profiles of septic shock patients based upon co-morbidities and other underlying conditions.

机构信息

Centre of Biomedical Research, SGPGIMS Campus, Raebareli Road, Lucknow, 226014, India.

出版信息

Mol Omics. 2021 Apr 1;17(2):260-276. doi: 10.1039/d0mo00177e. Epub 2021 Jan 5.

DOI:10.1039/d0mo00177e
PMID:33399607
Abstract

Diagnosis and management of patients with septic shock is still a significant challenge for clinicians with its high mortality amongst hospitalized patients. Septic shock is a heterogeneous condition and is usually accompanied by various underlying disease conditions. Dissecting the specific metabolic changes induced by these underlying disease conditions through metabolomics has shown the potential to improve our understanding of the disease's relevant pathophysiological mechanisms, leading to improved treatment. This study has shown the metabolic alterations caused due to co-morbid conditions like diabetes, hypertension, CAD, and CKD in septic shock. It has also shown the distinct metabolic profiles of septic shock patients with underlying respiratory illnesses and encephalopathy. Metabolic profiling of sera obtained from 50 septic shock patients and 20 healthy controls was performed using high-resolution 1D H CPMG and diffusion-edited NMR spectra. Univariate and multivariate statistical analyses were performed to identify the potential molecular biomarkers. Noted dysregulations in amino acids, carbohydrates, and lipid metabolism were observed in septic shock patients. Further stratification within the septic shock patients based on co-morbid conditions and primary diagnosis has shown their role in causing metabolic alterations. Evaluation of these compounds during treatment will help design a personalized treatment protocol for the patients, improving therapeutics.

摘要

脓毒性休克患者的诊断和治疗仍然是临床医生面临的重大挑战,住院患者的死亡率很高。脓毒性休克是一种异质性疾病,通常伴有各种基础疾病。通过代谢组学分析这些基础疾病引起的特定代谢变化,显示出有可能加深我们对相关病理生理机制的理解,从而改善治疗效果。本研究显示了糖尿病、高血压、冠心病和慢性肾脏病等合并症引起的脓毒性休克的代谢改变。它还显示了患有基础呼吸系统疾病和脑病的脓毒性休克患者的独特代谢特征。对 50 名脓毒性休克患者和 20 名健康对照者的血清进行了高分辨率 1D H CPMG 和扩散编辑 NMR 谱代谢谱分析。采用单变量和多变量统计分析方法鉴定潜在的分子生物标志物。观察到脓毒性休克患者的氨基酸、碳水化合物和脂质代谢出现明显失调。根据合并症和主要诊断对脓毒性休克患者进行进一步分层,显示了它们在引起代谢改变中的作用。在治疗过程中评估这些化合物将有助于为患者设计个性化的治疗方案,从而改善治疗效果。

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