Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, 430015, China; College of Life Sciences, Central China Normal University, Wuhan, 430079, China.
Clin Chim Acta. 2023 Apr 1;544:117330. doi: 10.1016/j.cca.2023.117330. Epub 2023 Apr 8.
To explore the maternal metabolic changes of fetal congenital heart disease (FCHD), and screen metabolic markers to establish a practical diagnostic model.
Maternal peripheral serum from 17 FCHD and 63 non-FCHD pregnant were analyzed by Ultra High-performance Liquid Chromatography-Mass/Mass (UPLC-MS/MS).
In the FCHD and the non-FCHD, 132 metabolites were identified, including 35 differential metabolites enriched in the purine, caffeine, primary bile acid, and arachidonic acid metabolism pathway. Finally, the screened (+/-)9,10-dihydroxy-12Z-octadecenoic acid (AUC = 0.888) and 11,12-epoxy-(5Z,8Z,11Z)-icosatrienoic acid (AUC = 0.995) were incorporated into the logistic regression model. The AUC value of the two-metabolite model was 1.0, superior to proline (AUC = 0.867), uric acid (AUC = 0.789), glutamine (AUC = 0.705), and taurine (AUC = 0.923) previously reported. The clinical decision curve analysis (DCA) showed the highest clinical net benefit of the model, and internal validation by bootstrap shows the robustness of the model (Brier Score = 0.005).
For the prenatal diagnosis of CHD, our findings are of great clinical significance. As an additional screening procedure, the identification model might be used to detect.
探讨胎儿先天性心脏病(FCHD)的母体代谢变化,并筛选代谢标志物建立实用的诊断模型。
采用超高效液相色谱-质谱/质谱(UPLC-MS/MS)对 17 例 FCHD 孕妇和 63 例非 FCHD 孕妇的外周血清进行分析。
在 FCHD 和非 FCHD 中,共鉴定出 132 种代谢物,包括 35 种差异代谢物,这些代谢物富集在嘌呤、咖啡因、初级胆汁酸和花生四烯酸代谢途径中。最后,筛选出(+/-)9,10-二羟基-12Z-十八碳烯酸(AUC=0.888)和 11,12-环氧-(5Z,8Z,11Z)-二十碳三烯酸(AUC=0.995),并纳入逻辑回归模型。该双代谢物模型的 AUC 值为 1.0,优于先前报道的脯氨酸(AUC=0.867)、尿酸(AUC=0.789)、谷氨酰胺(AUC=0.705)和牛磺酸(AUC=0.923)。临床决策曲线分析(DCA)显示该模型具有最高的临床净效益,内部验证通过自举法显示模型具有稳健性(Brier 得分=0.005)。
对于 CHD 的产前诊断,本研究结果具有重要的临床意义。作为附加的筛选程序,该识别模型可用于检测。