一种用于预测慢性阻塞性肺疾病患者急性加重的新型代谢评分。

A Novel Metabolic Score for Predicting the Acute Exacerbation in Patients with Chronic Obstructive Pulmonary Disease.

机构信息

Department of Critical Care Medicine, Qiannan Buyi and Miao Autonomous Prefecture People's Hospital, Guizhou, People's Republic of China.

Department of Respiratory Medicine, Guangming Traditional Chinese Medicine Hospital of Pudong New Area, Shanghai, People's Republic of China.

出版信息

Int J Chron Obstruct Pulmon Dis. 2023 May 5;18:785-795. doi: 10.2147/COPD.S405547. eCollection 2023.

DOI:10.2147/COPD.S405547

PMID:37180750

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10168002/

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) has higher mortality when developing to acute exacerbation (AECOPD); hence, the early intervention of COPD is critical for preventing AECOPD. Exploring the serum metabolites associated with acute exacerbation in patients with COPD will contribute to the early intervention of COPD.

METHODS

In the study, a non-targeted metabolomics strategy combined with multivariate statistical methods was performed to explore the metabolic profiling of COPD developing acute exacerbation, to screen the potential metabolites associated with AECOPD and to analyze the potential value of these metabolites in predicting the development of COPD.

RESULTS

Serum lysine, glutamine, 3-hydroxybutyrate, pyruvate and glutamate levels were significantly higher, while 1-methylhistidine, isoleucine, choline, valine, alanine, histidine and leucine levels were significantly lower in AECOPD patients, compared with stable COPD patients after normalization based on the healthy controls. Moreover, eight metabolic pathways were significantly altered (P<0.05) in the serum of AECOPD patients compared with the stable COPD population, including purine metabolism, glutamine and glutamate metabolism, arginine biosynthesis, butyrate metabolism, ketone body synthesis and degradation, and linoleic acid metabolism. In addition, the correlation analysis between metabolites and AECOPD patients demonstrated that an M-score based on a weighted sum of concentrations of four metabolites including pyruvate, isoleucine, 1-methylhistidine and glutamine were significantly associated with the acute exacerbation of pulmonary ventilation function in COPD patients.

CONCLUSION

Altogether, the metabolite score based on a weighted sum of concentrations of four serum metabolites was associated with an increased risk of COPD developing acute exacerbation, which will provide a new insight for the understanding of COPD development.

摘要

背景

慢性阻塞性肺疾病（COPD）发展为急性加重（AECOPD）时死亡率更高；因此，COPD 的早期干预对于预防 AECOPD 至关重要。探索与 COPD 急性加重相关的血清代谢物将有助于 COPD 的早期干预。

方法

在这项研究中，采用非靶向代谢组学策略结合多变量统计方法，探讨 COPD 发展为急性加重的代谢谱，筛选与 AECOPD 相关的潜在代谢物，并分析这些代谢物在预测 COPD 发展中的潜在价值。

结果

与稳定期 COPD 患者相比，AECOPD 患者的血清赖氨酸、谷氨酰胺、3-羟基丁酸、丙酮酸和谷氨酸水平显著升高，而 1-甲基组氨酸、异亮氨酸、胆碱、缬氨酸、丙氨酸、组氨酸和亮氨酸水平显著降低。此外，与稳定期 COPD 人群相比，AECOPD 患者的血清中有 8 条代谢途径发生了显著改变（P<0.05），包括嘌呤代谢、谷氨酰胺和谷氨酸代谢、精氨酸生物合成、丁酸代谢、酮体合成和降解以及亚油酸代谢。此外，代谢物与 AECOPD 患者的相关性分析表明，基于丙酮酸、异亮氨酸、1-甲基组氨酸和谷氨酰胺四种代谢物浓度加权和的 M 评分与 COPD 患者肺通气功能的急性加重显著相关。