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脂质代谢产物 9,10-DOA 和 11,12-EET 在胎儿心脏缺陷产前诊断中的价值。

The value of lipid metabolites 9,10-DOA and 11,12-EET in prenatal diagnosis of fetal heart defects.

机构信息

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.

出版信息

Clin Chim Acta. 2023 Apr 1;544:117330. doi: 10.1016/j.cca.2023.117330. Epub 2023 Apr 8.

Abstract

AIMS

To explore the maternal metabolic changes of fetal congenital heart disease (FCHD), and screen metabolic markers to establish a practical diagnostic model.

METHODS

Maternal peripheral serum from 17 FCHD and 63 non-FCHD pregnant were analyzed by Ultra High-performance Liquid Chromatography-Mass/Mass (UPLC-MS/MS).

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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