Liu Xiao-Lan, Li Wen-Zhong, Zhang Qian, Wang Xue-Mei, Zhou Yu-Ru, Wu Cheng-Gao, Xiong Si-Min, LE Ai-Ping, Zhang Zhang-Lin
Department of Clinical Laboratory, Ganzhou Women and Children's Health Care Hospital, Ganzhou 341000, Jiangxi Province, China.
Department of Blood Transfusion, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Apr;32(2):525-531. doi: 10.19746/j.cnki.issn.1009-2137.2024.02.031.
To explore the plasma metabolomic characteristics of children with transfusion-dependent thalassemia (TDT), and reveal the changes of metabolic pattern in children with TDT.
23 children with TDT who received regular blood transfusion in Ganzhou Women and Children's Health Care Hospital in 2021 were selected, and 11 healthy children who underwent physical examination during the same period were selected as the control group. The routine indexes between children with TDT and the control group were compared, and then the metabolic composition of plasma samples from children with TDT and the control group was detected by liquid chromatography-mass spectrometry. An OPLS-DA model was established to perform differential analysis on the detected metabolites, and the differential metabolic pathways between the two groups were analyzed based on the differential metabolites.
The results of routine testing showed that the indexes of ferritin, bilirubin, total bile acid, glucose and triglycerides in children with TDT were significantly higher than those in healthy controls, while hemoglobin and total cholesterol were significantly lower (all <0.05). However there was no significant difference in lactate dehydrogenase between the two groups ( >0.05). Compared with the control group, 190 differential metabolites (VIP>1) were identified in TDT children. Among them, 168 compounds such as arginine, proline and glycocholic acid were significantly increased, while the other 22 compounds such as myristic acid, eleostearic acid, palmitic acid and linoleic acid were significantly decreased. The metabolic pathway analysis showed that the metabolic impact of TDT on children mainly focused on the upregulation of amino acid metabolism and downregulation of lipid metabolism.
The amino acid and lipid metabolism in children with TDT were significantly changed compared with the healthy control group. This finding is helpful to optimize the treatment choice for children with TDT, and provides a new idea for clinical treatment.
探讨输血依赖型地中海贫血(TDT)患儿的血浆代谢组学特征,揭示TDT患儿代谢模式的变化。
选取2021年在赣州市妇幼保健院接受定期输血的23例TDT患儿,同期选取11例进行体检的健康儿童作为对照组。比较TDT患儿与对照组的常规指标,然后采用液相色谱 - 质谱联用技术检测TDT患儿与对照组血浆样本的代谢成分。建立OPLS - DA模型对检测到的代谢物进行差异分析,并基于差异代谢物分析两组之间的差异代谢途径。
常规检测结果显示,TDT患儿的铁蛋白、胆红素、总胆汁酸、葡萄糖和甘油三酯指标显著高于健康对照组,而血红蛋白和总胆固醇显著低于健康对照组(均P<0.05)。然而,两组之间乳酸脱氢酶无显著差异(P>0.05)。与对照组相比,TDT患儿中鉴定出190种差异代谢物(VIP>1)。其中,精氨酸、脯氨酸和甘氨胆酸等168种化合物显著增加,而肉豆蔻酸、桐油酸、棕榈酸和亚油酸等其他22种化合物显著减少。代谢途径分析表明,TDT对患儿的代谢影响主要集中在氨基酸代谢上调和脂质代谢下调。
与健康对照组相比,TDT患儿的氨基酸和脂质代谢发生了显著变化。这一发现有助于优化TDT患儿的治疗选择,并为临床治疗提供新思路。