Differential analysis of urinary metabolites of premature infants with bronchopulmonary dysplasia within 36 hours after birth / 中国新生儿科杂志

ABSTRACT

Objective To study the characteristics of urinary metabolites in the premature infants with or without bronchopulmonary dysplasia (BPD) within 36 hours after birth and to find new biomarkers for the early warning indicators for BPD.Method From January 2014 to October 2016,premature infants hospitalized in the Sixth Affiliated Hospital of Sun Yat-sen University with gestational age ＜ 32 weeks,hospitalization time ＞ 28 days and urine samples were collected within 36 hours after birth for metabolite detection were enrolled in the study.Preterm infants diagnosed as BPD were selected as the BPD group.Preterm infants with the same gestational age,days of age with the BPD group had no BPD were selected as the control group at a ratio of 1 ∶ 1.The gas chromatography-mass spectrometry was used to measure the metabolites.The data were analyzed using orthogonal partial least squares discriminant analysis and receiver operating characteristic (ROC) curve and the area under which were used to determine the performance of differential metabolites in the diagnosis of BPD.Result There were 20 patients in the BPD group and 20 patients in the control group.Within 36 hours after birth,in the BPD group,the level of fucose and tartrate in urine (nmol/mgCr) were significantly lower than that in the control group [0.00 (0.00,0.03)vs.0.07 (0.00,0.41);0.00 (0.00,0.01) vs.0.02 (0.00,0.06),respectively].The level of kynurenic acid and thymine (nmol/mgCr) were significantly higher than the level in the control group [0.04 (0.00,0.43) vs.0.00 (0.00,0.00);7.10 (0.00,14.47) vs.0.00 (0.00,0.22),respectively].All the differences were statistically significant (P ＜ 0.05).ROC curve analysis showed that the area under the curve for the diagnosis of BPD in combination with the four metabolites was 0.857 (95％ CI 0.732 ～0.982).Conclusion Changes in urinary metabolites such as fucose,thymine,kynurenine and tartaric acid in preterm infants may be related to the development of BPD.Early detection of these four metabolites has potential in the early diagnosis of BPD,and may warn against the occurrence of BPD.