糖尿病肾病患者血清色氨酸代谢谱的靶向研究*

目的: 研究糖尿病肾病(DKD)患者与健康对照人群血清色氨酸不同代谢通路中代谢物的差异,分析差异代谢物与临床指标之间的相关性。方法: 以包头医学院第一附属医院肾内科和内分泌科住院部患者为研究对象,选取10例DKD患者为疾病研究组,10例健康体检者为正常对照组,收集血液标本。采用靶向代谢组学方法分析两组人群中血清色氨酸及其代谢物的差异,进行生物信息学和统计学分析,阐明其在DKD中的意义。结果: 在两组血清中鉴定出5个差异代谢物,其中DKD患者血清中L-色氨酸(L-TRP)、5-羟色胺(5-HT)的水平明显低于健康对照组(P＜0.05),而5-羟基吲哚乙酸(5-HIAA)、犬尿氨酸(KYN)和3-吲哚丙酸(IPA)的水平则增加,差异具有统计学意义(P＜0.05),5-HIAA和IPA均与血肌酐呈显著正相关,与肾小球滤过率呈显著负相关。结论: DKD患者血清色氨酸代谢物水平与健康对照组相比具有明显的差异,其中的某些差异代谢物还与DKD的发生发展具有明显的相关性。

Targeted study of serum tryptophan metabolic profile in patients with diabetic kidney disease

Objective: To study the differences of metabolites in different metabolic pathways of serum tryptophan in patients with diabetic kidney disease (DKD) and healthy controls, and analyze the correlation between differential metabolites and clinical indicators. Method: Taking patients in the Nephrology Department and Endocrinology Department of the First Affiliated Hospital of Baotou Medical College as the research objects, 10 DKD patients were selected as the disease study group, and 10 healthy subjects were selected as the normal control group, and blood samples were collected. The differences of serum tryptophan and its metabolites in the two groups were analyzed by targeted metabolomics method, and then biological information analysis and statistical analysis were performed to clarify its significance in DKD. Results: Five differential metabolites were identified in the serum of DKD patients and healthy controls. The levels of L-tryptophan (L-TRP) and serotonin (5-HT) in serum of DKD patients were significantly lower than those of healthy controls,the difference was statistically significant (P＜0.05).While the levels of 5-hydroxyindoleacetic acid (5-HIAA), kynurenine (KYN), and 3-indolepropionic acid (IPA) are increased, the difference was also statistically significant(P＜0.05). There was a significant positive correlation between 5-HIAA and IPA with serum creatinine, and a significant negative correlation with glomerular filtration rate. Conclusions: Serum tryptophan metabolite levels in DKD patients were significantly different from those in healthy controls, and some of the differential metabolites are also significantly correlated with the occurrence and development of DKD.