The Value And Correlation Of Targeted Metabolomics Of Serum Bile Acid Profile In Early Diagnosis Of Acute Pancreatitis

OBJECTIVEThrough to the healthy control group and Mild Acute Pancreatitis(MAP)、Moderate Severe Acute Pancreatitis(MSAP)、Severe Acute Pancreatitis(SAP)targeted metabonomics detection of serum conjugated bile acid,look for specific bile acid,with the value of early diagnosis and combined with clinical markers for correlation analysis,to the early diagnosis of acute pancreatitis(AP)and future therapeutic targets to provide new train of thought and basis,To improve the curative effect and prognosis of acute pancreatitis.METHODSUltra performance liquid chromatography high resolution mass spectrometry(UPLC-HRMS)was used to detect serum bile acids in 75 patients with acute pancreatitis who were hospitalized in Baotou Central Hospital from September 2019 to September 2021 and 75 healthy persons who met the inclusion criteria.Univariate statistical analysis and multivariate statistical analysis were combined to analyze the difference of bile acid spectrum between patients with acute pancreatitis in different groups and healthy controls.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of differential metabolic markers and find the internal mechanism of action.Finally,Correlation heat map was used to analyze the correlation between clinical laboratory indicators and specific bile acids.RESULTS1.Using univariate statistical analysis of single factor analysis of variance on the MAP,MSAP,SAP patients and healthy controls general data statistical analysis showed that age,gender,no statistical difference between groups,P > 0.05,Amylase(AMS),Lipase(LPS),Urine Amylase(UAMY),Glucose(Glu),Total Cholesterol(TC),Triglyceride(TG),blood calcium was statistically difference between groups,P < 0.05,and then USES the rank and inspection of biochemical indicators between the group two comparison shows: the control group with the MAP,MSAP,SAP in AMS,LPS,Glu,TC has a statistically significant,P < 0.05,and the control group with the MAP,MSAP,SAP,MAP and MSAP,MSAP compared with SAP in two two UAMY statistically significant,P < 0.05,the control group and MSAP,SAP,MAP and MSAP,SAP in blood calcium,two two compared statistically significant(P < 0.05).2.By isotope internal standard method and ultra performance liquid chromatography high resolution mass spectrometry for bile acid spectrum targeted detection of serum samples,a total of 14 bile acids were detected:cholic acid(CA),taurolithocholic acid(TLCA),glycolithocholic acid(GLCA),glycholic acid(GCA),taurocholic acid(TCA),deoxycholic acid(DCA),chenodeoxycholic acid(CDCA),ursodeoxycholic acid(UDCA),glycodeoxycholic acid(GDCA),glycochenodeoxycholic acid(GCDCA),glycoursodeoxycholic acid(GUDCA),taurodeoxycholic acid(TDCA),taurochenodeoxycholic acid(TCDCA),tauroursodeoxycholic acid(TUDCA).The box diagram showed that the expression of glycine cholic acid was increased in the control group,UDCA in the MSAP group,and GDCA,TCDCA,TDCA,TUDCA and GCA in the SAP group.3.TCA was screened by OPLS-DA and ROC curve as the differential metabolites to distinguish the moderate acute pancreatitis group from the healthy control group,and TCDCA,GCA,TDCA and TCA were screened as the differential metabolites to distinguish the severe acute pancreatitis group from the healthy control group.At the same time,differential bile acids were screened by clustering heat map.4.Correlation heat map showed positive correlation between TCDCA and Glu,TLCA and TG,CA and TC in the group of moderate severe acute pancreatitis.In severe acute pancreatitis group,TLCA,GCDCA were positively correlated with serum calcium,GDCA,CDCA were positively correlated with UAMY,GDCA was positively correlated with LPS.CONCLUSIONSerum specific bile acids are expected to be the basis for the early,non-invasive and accurate diagnosis of MSAP and SAP,providing a new method for early diagnosis and a new idea and basis for the treatment of AP in the future.