足月小于胎龄新生儿血氨基酸谱和酰基肉碱谱分析  

Analysis of amino acid and acylcarnitine profile in full-term newborns small for gestational age

作　　者：熊慧[1] 李思涛[1] 马艳梅[2] 古霞 肖昕[1] 郝虎[1] Xiong Hui;Li Sitao;Ma Yanmei;Gu Xia;Xiao Xin;Hao Hu(Department of Pediatrics,the Sixth Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510655,China;Inborn Errors of Metabolism Laboratory,the Sixth Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院儿科,广州510655 [2]中山大学附属第六医院遗传代谢病实验室,广州510655

出　　处：《中华实用儿科临床杂志》2020年第17期1346-1350,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：广东省医学科学技术研究基金(A2018263)。

摘　　要：目的比较足月小于胎龄(SGA)新生儿和与之配对的足月适于胎龄儿(AGA)血氨基酸和酰基肉碱的差异,探讨足月SGA血代谢谱的变化,为临床干预提供依据。方法选择2018年1月至12月在中山大学附属第六医院出生的79例足月SGA为研究对象,同期在本院出生的按胎龄、性别匹配的79例健康足月AGA为对照,出生后第3天采集干血滤纸片样品进行串联质谱分析,应用正交偏最小乘判别分析(OPLS-DA)寻找2组间的差异和生物标志物。结果足月SGA组出生体质量(2.5±0.2)kg,足月AGA组出生体质量(3.2±0.3)kg。通过OPLS-DA模型分析发现12种权重较大的血代谢物质及2组血代谢物比值分别为:丙酰基肉碱(0.34±0.13比0.42±0.15)、酪氨酸[0.24(0.18,0.27)比0.28(0.22,0.37)]、游离肉碱(0.43±0.14比0.37±0.12)、缬氨酸[0.39(0.35,0.45)比0.44(0.36,0.53)]、辛酰基肉碱(0.33±0.13比0.29±0.09)、肉豆蔻二烯酰基肉碱(0.35±0.12比0.31±0.10)、丁酰基肉碱(0.37±0.13比0.41±0.14)、3-羟基异戊酰基肉碱[0.35(0.25,0.43)比0.35(0.26,0.45)]、葵酰基肉碱(0.26±0.13比0.23±0.08)、异戊烯酰基肉碱[0.33(0.26,0.34)比0.33(0.30,0.35)]、亮氨酸[0.38(0.30,0.47)比0.40(0.33,0.48)]、甲硫氨酸(0.42±0.14比0.46±0.15),其中丙酰基肉碱(t=3.920)、酪氨酸(Z=3.536)和缬氨酸(Z=2.838)在足月SGA组明显降低,而游离肉碱(t=-2.863)、辛酰基肉碱(t=-2.266)和肉豆蔻二烯酰基肉碱(t=-2.194)明显升高,与足月AGA组相比差异均有统计学意义(均P<0.05)。结论足月SGA新生儿出生后早期血液中氨基酸和酰基肉碱水平与足月AGA存在差异。足月SGA新生儿营养支持中需适量补充芳香族氨基酸和支链氨基酸;其出生后早期通过动员中长链脂肪酸来满足机体能量代谢。Objective To compare the difference of blood amino acids and acylcarnitine levels between small-for-gestational-age(SGA)and appropriate-for-gestational age(AGA)full-term newborns,and to explore the changes of the blood metabolism spectrum of full-term SGA,so as to provide evidence for clinical intervention.Methods Seventy-nine full-term SGA newborns born in the Sixth Affiliated Hospital of Sun Yat-Sen University from January to December 2018 were selected as the study objects.Seventy-nine gestational age-and gender-matched healthy full-term AGA newborns born in the same hospital at the same time were selected as the control group.The dry blood spot samples were collected and detected by tandem mass spectrometry on the third day after birth.The differences between two groups and considerable biomarkers were explored by the orthogonal partial least squares discriminant analysis(OPLS-DA).Results The birth weight of SGA newborns was(2.5±0.2)kg,and that of AGA newborns was(3.2±0.3)kg.OPLS-DA model analysis showed that 12 kinds of blood metabolites were identified which possessed the biggest weight discriminating the full-term SGA group from the AGA group,and the ratios of these blood metabolites of two groups were compared as follows:propionylcarnitine(0.34±0.13 vs.0.42±0.15),tyrosine[0.24(0.18,0.27)vs.0.28(0.22,0.37)],free carnitine(0.43±0.14 vs.0.37±0.12),valine[0.39(0.35,0.45)vs.0.44(0.36,0.53)],octanoylcarnitine(0.33±0.13 vs.0.29±0.09),myristoylcarnitine(0.35±0.12 vs.0.31±0.10),butylcartine(0.37±0.13 vs.0.41±0.14),3-hydroxyisovlerylcartine[0.35(0.25,0.43)vs.0.35(0.26,0.45)],decenoylcarnitine(0.26±0.13 vs.0.23±0.08),isovalerylcarnitine[0.33(0.26,0.34)vs.0.33(0.30,0.35)],leucine[0.38(0.30,0.47)vs.0.40(0.33,0.48)]and methionine(0.42±0.14 vs.0.46±0.15).The level of propionylcarnitine(t=3.920),tyrosine(Z=3.536)and valine(Z=2.838)in the full-term SGA group were significantly lower than those in the AGA group,while the levels of free carnitine(t=-2.863),octanoylcarnitine(t=-2.266)and myristoylcarnitine(t=

关 键 词：氨基酸 酰基肉碱 代谢谱 小于胎龄儿 足月 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]