Clinical Study On Acute Pancreatitis Classification Based On Metabolomics

Objective: Using gas chromatography-mass spectrometry(GC-MS)and random forest(RF)metabolomic methods to screen for the potential serum metabolic markers of inflammationin in hyperlipidemia acute pancreatitis(HLAP),biliary acute pancreatitis(BAP)and alcoholic acute pancreas(AAP)in order to achieve early identification of different types of AP,and to study the causes,optimize the better treatment plan,treat the cause as early as possible,and serve the patients to reduce disease complications,critical rate,and death rate.Methods: Acute pancreatitis(AP)patients who were hospitalized in the intensive care unit(EICU)of Hunan Provincial People’s Hospital from January 30,2017 to December 24,2018 were collected and screened according to the inclusion and exclusion criteria,and finally 29 HLAP Patients(HLAP group),20 AAP patients(AAP group)and 27 BAP patients(BAP group)were selected as the test group,and 15 healthy persons were selected as the control group.Drawing the fasting blood of all participants in the early morning of the next day,after centrifugation,purification,enrichment and other treatments,we use GC-MS method to detect the endogenous small molecules in the serum of the participants to obtain their metabolic profile: useing RF algorithm statistics to Analyze and to compare the similarities and differences of metabolites between groups,we find the differential metabolic markers of each group,and analyze their metabolic pathways by bioinformatics methods.Results: Compared with healthy controls,the 34 metabolites involved in the metabolic processes of amino acids,carbohydrates,energy,and lipids in AP patients were significantly changed.In addition,compared with the healthy control group,the classification accuracy of BAP,HLAP,and AAP patients was 0.886,0.920,and 0.962,respectively.And some special metabolic markers of each AP were found,such as L-lactic acid,(R)-3-hydroxybutyric acid,phosphate,glycine,L-phenylalanine,D-galactose,L-tyrosine,Arachidonic acid,glycerol 1-hexadecanoate,etc.Among them,the glycine level in the BAP group was significantly lower than that in the healthy control group,and the L-lysine level was significantly increased;compared with the healthy control group,the tyrosine and phenylalanine levels in the HLAP group were significantly reduced;AA levels decreased significantly;3-hydroxybutyric acid levels in the HLAP and AAP groups were significantly lower than in the HLAP group;In addition,associations between these metabolites and amino acid and fatty acid metabolism were identified.There were no differences in metabolites between the HLAP and AAP groups.Conclusion: The results of the study show that the differences in metabolites characterized by GC-MS metabolomics can help distinguish patients from healthy control groups,BAP,HLAP,and AAP groups.This study explored and explained the metabolism of different types of AP based on different metabolic pathways.Markers and physiological functions indicate that metabolomics is an effective research method for studying the molecular mechanisms involved in the etiology of BAP,AAP,and HLAP,and discovering new therapeutic targets.This method will help clinicians to identify the causes of different types of AP in the early stage,and adjust the treatment plan in time to reduce complications,critical illness rate and mortality.