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基于代谢组学的百草枯暴露患者急性肾损伤风险早期预警模型

Metabolomics based early warning model for acute kidney injury risk in patients exposed to diquat.

作者信息

Zhu Shengkai, Li Xinyu, Wu Chengzhao, Zhao Xu, Xu Shuiying, Zhao Yujing, Peng Xiaobo, Xiao Xiaohe, Niu Ming

机构信息

College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Department of Liver Disease, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.

Department of Liver Disease, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.

出版信息

Toxicol Appl Pharmacol. 2025 Feb;495:117207. doi: 10.1016/j.taap.2024.117207. Epub 2024 Dec 16.

Abstract

Acute kidney injury (AKI) is one of the most important indications of severe clinical symptoms in patients with diquat poisoning and is closely related to poor prognosis. However, current studies have rarely focused on early warnings of diquat-related AKI, which is not conducive to the treatment of patients with early clinical diquat poisoning. In this study, untargeted plasma metabolomics was employed to reveal the differences between diquat-poisoned patients with and without AKI, as well as between patients and healthy volunteers. The results showed that 48 metabolites were significantly changed in the patients, among which 3-hydroxybutyrylcarnitine, SAICAR, dodecanoic acid, and tetrahydrofolyl-Glu could be used to effectively differentiate the above three groups. Based on the ratios of the first two metabolites and the ratios of the last two metabolites, a decision tree model for the early warning of diquat-induced AKI was established with an accuracy rate of 88.7 %. This model provides great support for accurate clinical diagnosis and intervention regarding the AKI risk of diquat-exposed patients.

摘要

急性肾损伤(AKI)是百草枯中毒患者严重临床症状的重要指征之一,且与预后不良密切相关。然而,目前的研究很少关注百草枯相关急性肾损伤的早期预警,这不利于百草枯中毒患者的早期临床治疗。在本研究中,采用非靶向血浆代谢组学方法揭示了百草枯中毒合并急性肾损伤患者与未合并急性肾损伤患者之间以及患者与健康志愿者之间的差异。结果显示,患者体内48种代谢物发生了显著变化,其中3-羟基丁酰肉碱、SAICAR、十二烷酸和四氢叶酸-谷氨酸可有效区分上述三组。基于前两种代谢物的比值和后两种代谢物的比值,建立了百草枯诱导急性肾损伤的早期预警决策树模型,准确率为88.7%。该模型为准确临床诊断和干预百草枯暴露患者的急性肾损伤风险提供了有力支持。

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