类风湿关节炎患者血清代谢物谱特征研究  

Characterization of serum metabolite profile in patients with rheumatoid arthritis

作　　者：邝涛[1,2] 李鑫[1] 林也 魏艳霞[1] 李如意[1] 邵峰[1] 王莘智[3] 黄惠勇[1] 蔡雄 

机构地区：[1]湖南中医药大学中医诊断学湖南省重点实验室,长沙410208 [2]湖南中医药大学附属第一医院骨伤科,长沙410007 [3]湖南中医药大学附属第一医院风湿科,长沙410007 [4]广东药科大学中药学院,广州510006

出　　处：《中国医师杂志》2017年第11期1635-1640,共6页Journal of Chinese Physician

基　　金：国家自然科学基金项目（81373540）;中国博士后科学基金第60批面上资助项目（2016M600632）、第10批特别资助项目（2017T100604）;湖南省战略性新兴产业科技攻关类重大核心技术类项目（2014GK1058）;湖南省高层次卫生人才“225”工程医学学科骨干人才培养对象项目;湖南中医药大学中医诊断国家重点学科开放基金项目（2014-08,2015ZYZD05,2015ZYZD15）;湖南中医药大学“科技创新团队”资助项目（201503）

摘　　要：目的探究类风湿关节炎（RA）患者血清代谢物谱特征，为其临床诊断提供有益探索。方法采集2016年1月至4月间，于湖南中医药大学第一附属医院风湿科就诊的RA住院患者血清样本26例，并采集同时期健康体检科的健康志愿者血清样本19例。采用气相色谱．质谱联用技术（GC—MS）进行代谢物检测，化学计量学分辨方法鉴定代谢物。采用偏最小二乘．线性判别分析（PLS．LDA）建立RA患者和健康志愿者判别模型，子窗口重排法（SPA）筛选有潜在临床应用价值的差异代谢物。结果48种代谢物被准确鉴定，PLS-LDA判别模型总预测正确率为97．73％，其中RA判别正确率为96．15％，健康志愿者判别正确率为100％。初步筛选出3-羟基丁酸、磷酸、异亮氨酸、甘露糖和十六烷酸等有潜在临床应用价值的代谢物。结论采用代谢组学技术能较好区分RA患者和健康志愿者，为RA临床诊断提供新的思路。Objective To investigate and characterize the serum metabolite profile of patients with rheumatoid arthritis （ RA）, a common autoimmune disease, which will be of help for early diagnosis in clinic. Methods Serum specimens from 26 patients with RA and 19 age-matched healthy volunteers were col- lected from the First Affiliated Hospital of Hunan University of Chinese Medicine from January through April 2015. Samples were detected on the gas chromatography-mass spectrometry （GC-MS）, and serum metabolites were identified by the chemometric methods. Discriminative model of RA and healthy volunteers was established using partial least squares-linear discriminant analysis （PLS-LDA） , and furthermore the estab- lished model was evaluated with double cross validation （DCV） for predicting ability. Finally, differential metabolites with clinical diagnostic potential were screened out by using subwindow permutation analysis （SPA）. Results The established PLS-LDA discriminative model identified 48 metabolites. The total accuracy of the model approached 97.73 % , in which the accuracy of the model for predicting RA and healthy volunteers was 96. 15% and 100% , respectively. Our studies screened out 3-hydroxy butyric acid, phos- phoric acid, isoleueine, mannose and hexadecanoic acid with clinical diagnostic potential based on the SPA.Conclusions Metabolomics with the application of GC-MS combined with the PLS-LDA method can distinguish patients with RA and healthy volunteers, and can aid in potential early diagnosis of RA.

关 键 词：关节炎 类风湿/代谢 气相色谱-质谱法 

分 类 号：R593.22[医药卫生—内科学]