Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil.
Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil
BMJ Open. 2022 Apr 25;12(4):e054697. doi: 10.1136/bmjopen-2021-054697.
To determine the accuracy of metabolomics in predicting hypertensive disorders in pregnancy.
Systematic review of observational studies.
An electronic literature search was performed in June 2019 and February 2022. Two researchers independently selected studies published between 1998 and 2022 on metabolomic techniques applied to predict the condition; subsequently, they extracted data and performed quality assessment. Discrepancies were dealt with a third reviewer. The primary outcome was pre-eclampsia. Cohort or case-control studies were eligible when maternal samples were taken before diagnosis of the hypertensive disorder.
Data on study design, maternal characteristics, how hypertension was diagnosed, metabolomics details and metabolites, and accuracy were independently extracted by two authors.
Among 4613 initially identified studies on metabolomics, 68 were read in full text and 32 articles were included. Studies were excluded due to duplicated data, study design or lack of identification of metabolites. Metabolomics was applied mainly in the second trimester; the most common technique was liquid-chromatography coupled to mass spectrometry. Among the 122 different metabolites found, there were 23 amino acids and 21 fatty acids. Most of the metabolites were involved with ammonia recycling; amino acid metabolism; arachidonic acid metabolism; lipid transport, metabolism and peroxidation; fatty acid metabolism; cell signalling; galactose metabolism; nucleotide sugars metabolism; lactose degradation; and glycerolipid metabolism. Only citrate was a common metabolite for prediction of early-onset and late-onset pre-eclampsia. Vitamin D was the only metabolite in common for pre-eclampsia and gestational hypertension prediction. Meta-analysis was not performed due to lack of appropriate standardised data.
Metabolite signatures may contribute to further insights into the pathogenesis of pre-eclampsia and support screening tests. Nevertheless, it is mandatory to validate such methods in larger studies with a heterogeneous population to ascertain the potential for their use in clinical practice.
CRD42018097409.
确定代谢组学在预测妊娠高血压疾病中的准确性。
观察性研究的系统评价。
2019 年 6 月和 2022 年 2 月进行了电子文献检索。两名研究人员独立选择了 1998 年至 2022 年期间发表的关于代谢组学技术应用于预测该疾病的研究；随后，他们提取数据并进行质量评估。分歧由第三位审稿人处理。主要结局是子痫前期。当母亲样本在高血压疾病诊断前采集时，队列或病例对照研究符合条件。
两名作者独立提取研究设计、产妇特征、高血压诊断方式、代谢组学细节和代谢产物以及准确性的数据。
在最初确定的 4613 项代谢组学研究中，有 68 项进行了全文阅读，有 32 项文章被纳入。由于数据重复、研究设计或代谢产物识别缺乏，研究被排除在外。代谢组学主要应用于孕中期；最常见的技术是液相色谱-质谱联用。在发现的 122 种不同代谢产物中，有 23 种氨基酸和 21 种脂肪酸。大多数代谢产物与氨循环；氨基酸代谢；花生四烯酸代谢；脂质转运、代谢和过氧化；脂肪酸代谢；细胞信号；半乳糖代谢；核苷酸糖代谢；乳糖降解；和甘油脂质代谢有关。只有柠檬酸是预测早发型和晚发型子痫前期的常见代谢产物。维生素 D 是子痫前期和妊娠期高血压预测的唯一共同代谢产物。由于缺乏适当的标准化数据，未进行荟萃分析。
代谢产物特征可能有助于进一步了解子痫前期的发病机制，并支持筛查试验。然而，必须在具有异质性人群的更大研究中验证这些方法，以确定其在临床实践中的应用潜力。
PROSPERO 注册号：CRD42018097409。
