Metabolomics combined with machine learning algorithms in exploring biomarkers of early postoperative cognitive dysfunction after heart valve replacement

CHEN Wei; SHE Han; TANG Xiao-feng; CHEN Wei; LIU Liang-ming; LI Tao; HU Yi

doi:10.11659/jjssx.05E024081

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Metabolomics combined with machine learning algorithms in exploring biomarkers of early postoperative cognitive dysfunction after heart valve replacement

Clinical Research | 更新时间：2025-04-17

- Metabolomics combined with machine learning algorithms in exploring biomarkers of early postoperative cognitive dysfunction after heart valve replacement
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 4, Pages: 310-314(2025)
- 作者机构：
  
  1.陆军特色医学中心麻醉科，重庆 400042
  2.野战外科研究部战伤休克与输血研究室/创伤、烧伤与复合伤国家重点实验室，重庆 400042
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.05E024081
  CLC： R614
- Received：16 June 2024，
  
  Published：25 April 2025
- 稿件说明：
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陈薇,佘汉,唐小唪等.代谢组学结合机器学习算法探究心脏瓣膜置换术后早期认知功能障碍生物标志物[J].局解手术学杂志,2025,34(04):310-314.

CHEN Wei,SHE Han,TANG Xiao-feng,et al.Metabolomics combined with machine learning algorithms in exploring biomarkers of early postoperative cognitive dysfunction after heart valve replacement[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(04):310-314.
陈薇,佘汉,唐小唪等.代谢组学结合机器学习算法探究心脏瓣膜置换术后早期认知功能障碍生物标志物[J].局解手术学杂志,2025,34(04):310-314. DOI： 10.11659/jjssx.05E024081.

CHEN Wei,SHE Han,TANG Xiao-feng,et al.Metabolomics combined with machine learning algorithms in exploring biomarkers of early postoperative cognitive dysfunction after heart valve replacement[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(04):310-314. DOI： 10.11659/jjssx.05E024081.

摘要

目的

通过代谢组学结合机器学习算法对心脏瓣膜置换术后早期认知功能障碍(POCD)的患者术前血清代谢物进行系统研究，筛选可预测心脏瓣膜置换术后早期POCD的生物标志物，并探讨相应的代谢调控机制。

方法

选择接受体外循环下心脏瓣膜置换术的患者60例，根据是否发生POCD将其分为早期POCD组（P组）和非POCD组（N组）。对P组和N组患者术前血清进行代谢组学分析，筛选差异代谢物及代谢通路。采用随机森林算法鉴定早期POCD的相关生物标志物。

结果

经代谢组学分析，共检测出532种差异代谢物，采用随机森林算法筛选出5种生物标志物，分别为喹啉、3'-唾液酸乳糖、鞘磷脂（d18∶1/20∶0）、溶血磷脂酰胆碱[P-18∶1(9Z)]和25-羟基胆固醇，其中富集到的主要代谢途径是苯丙氨酸代谢、初级胆汁酸生物合成、抗坏血酸和醛酸盐代谢、戊糖和葡萄糖酸盐的相互转化、色氨酸代谢、药物代谢-细胞色素P450、卟啉与叶绿素代谢。

结论

体外循环下心脏瓣膜置换术后发生早期POCD的患者术前多条代谢途径发生了变化，可能导致早期POCD的发生。喹啉、3'-唾液酸乳糖、鞘磷脂（d18∶1/20∶0）、溶血磷脂酰胆碱[P-18∶1(9Z)]和25-羟基胆固醇可能成为预测早期POCD的生物标志物。

Abstract

Objective

Metabolomics combined with machine learning algorithms was used to systematically study the preoperative serum metabolites of patients with early postoperative cognitive dysfunction （POCD） after heart valve replacement，so as to screen biomarkers that may predict early POCD after heart valve replacement and explore the corresponding metabolic regulatory mechanisms.

Methods

A total of 60 patients underwent heart valve replacement under extracorporeal circulation were selected and divided into early-POCD group （group P） and non-POCD group （group N） according to whether POCD occurred or not. Metabolomic analysis was performed on preoperative serum samples of patients in group P and group N to screen the differential metabolites and metabolic pathways. The biomarkers related to early POCD were identified by random forest algorithm.

Results

A total of 532 differential metabolites were detected by metabonomics analysis， and 5 biomarkers were screened by random forest algorithm， namely quinoline， 3'-sialyllactose， sphingomyelin （d18∶1/20∶0）， lysophosphatidylcholine ［P-18∶1（9Z）］ and 25-hydroxycholesterol. Among them， the main metabolic pathways were phenylalanine metabolism， primary bile acid biosynthesis， ascorbic acid and aldonate metabolism， pentose and glucuronate interconversion， tryptophan metabolism， drug metabolism-cytochrome P450， porphyrin and chlorophyll metabolism.

Conclusion

Many metabolic pathways in patients with early POCD after heart valve replacement under extracorporeal circulation have changed before operation， which may lead to the occurrence of early POCD. Quinoline， 3'-sialyllactose， sphingomyelin （d18∶1/20∶0）， lysophosphatidylcholine ［P-18∶1（9Z）］ and 25-hydroxycholesterol may be biomarkers for predicting early POCD.

关键词

Keywords

references

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