Xie Ming, Liu Yu, Zheng Hui, Gao Xiaoli, Liu Ran
North China Petroleum Bureau General Hospital, Renqiu, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
Front Med (Lausanne). 2023 Jun 2;10:1169038. doi: 10.3389/fmed.2023.1169038. eCollection 2023.
The important metabolic features of acute pulmonary embolism (APE) risk stratification and their underlying biological basis remain elusive. Our study aims to develop early diagnostic models and classification models by analyzing the plasma metabolic profile of patients with APE.
Serum samples were collected from 68 subjects, including 19 patients with confirmed APE, 35 patients with confirmed NSTEMI, and 14 healthy individuals. A comprehensive metabolic assessment was performed using ultra-performance liquid chromatography-mass spectrometry based on an untargeted metabolomics approach. In addition, an integrated machine learning strategy based on LASSO and logistic regression was used for feature selection and model building.
The metabolic profiles of patients with acute pulmonary embolism and NSTEMI is significantly altered relative to that of healthy individuals. KEGG pathway enrichment analysis revealed differential metabolites between acute pulmonary embolism and healthy individuals mainly involving glycerophosphate shuttle, riboflavin metabolism, and glycerolipid metabolism. A panel of biomarkers was defined to distinguish acute pulmonary embolism, NSTEMI, and healthy individuals with an area under the receiver operating characteristic curve exceeding 0.9 and higher than that of D-dimers.
This study contributes to a better understanding of the pathogenesis of APE and facilitates the discovery of new therapeutic targets. The metabolite panel can be used as a potential non-invasive diagnostic and risk stratification tool for APE.
急性肺栓塞（APE）风险分层的重要代谢特征及其潜在生物学基础仍不清楚。我们的研究旨在通过分析APE患者的血浆代谢谱来开发早期诊断模型和分类模型。
收集了68名受试者的血清样本，包括19例确诊的APE患者、35例确诊的非ST段抬高型心肌梗死（NSTEMI）患者和14名健康个体。基于非靶向代谢组学方法，使用超高效液相色谱-质谱联用技术进行全面的代谢评估。此外，基于套索（LASSO）和逻辑回归的集成机器学习策略用于特征选择和模型构建。
与健康个体相比，急性肺栓塞和NSTEMI患者的代谢谱有显著改变。京都基因与基因组百科全书（KEGG）通路富集分析显示，急性肺栓塞与健康个体之间的差异代谢物主要涉及磷酸甘油穿梭、核黄素代谢和甘油脂质代谢。定义了一组生物标志物以区分急性肺栓塞、NSTEMI和健康个体，其受试者工作特征曲线下面积超过0.9，且高于D-二聚体。
本研究有助于更好地理解APE的发病机制，并促进新治疗靶点的发现。代谢物组可作为APE潜在的非侵入性诊断和风险分层工具。
