Research On Serum And Urine Metabonomics Characteristics Of Primary Nephrotic Syndrome Patients With Spleen And Kidney Yang Deficiency

Objective:In this study, by means of metabolomics technology,Nuclear magnetic resonance spectroscopy(1H-NMR) spectrum analyses of serum,urine of healthy subjects and primary nephrotic syndrome(PNS) subjects with spleen kidney yang deficiency syndrome were conducted in order to seeking for potential biomarkers of PNS spleen kidney yang deficiency syndrome.Using metabonomics to explore TCM Syndrome Essence of PNS spleen and kidney yang deficiency syndrome,which could establish objective and quantitative scientific expression system of TCM typing,providing new ideas and methods for the TCM prevention and treatment of PNS.Method:In this research 25 cases in April 2014-May 2015 in our hospital diagnosed as primary nephrotic syndrome and syndrome of spleen kidney yang deficiency were enrolled as experimental study group,another 25 healthy subjects(healthy volunteers source of the patient's family) as normal control group.Subjects' serum, urine(morning urine) specimen was collected,as well as their sex, age, weight, height, blood biochemistry,urine and other biological information recorded.Serum, urine samples were detected by1H-NMR.The resulting NMR data was imported into SIMCA-P 13 software for multivariate statistical analysis after segmented integration.Firstly use unsupervised main component(PCA) analysis, and then the supervised(OPLS-DA) analysis.On the basis of effective model parameters,according to VIP values and load diagram(S-plot),metabolites difference was confirmed to identify material basis of TCM syndrome,exploring metabolite variation over PNS spleen and kidney yang deficiency syndrome.Result:(1)Visual analysis of serum, urine NMR spectrum between group PNS spleen kidney yang deficiency syndrome and normal control group shows that serum, urine composition of two groups is significantly different and there are significant differences.(2) According to S-plot and VIP value of serum NMR data between group PNS spleen kidney yang deficiency syndrome and normal control group,7 endogenous metabolites compared with normal control group were detected to be significant differences(P <0.05),Among which lipid, pyruvate content showed to be increased, and valine, leucine, Nacetyl glucosamine, glutamine, glycerol decreased(P<0.05).(3)According to S-plot and VIP value of urine NMR data between group PNS spleenkidney yang deficiency syndrome and normal control group,5 endogenous metabolites compared with normal control group were detected to be significant differences(P <0.05),Among which leucine, lactic acid, betaine content showed to be increased and creatinine, hippuric decreased(P<0.05).Conclusion:There are significant differences of serum, urine NMR spectrum between group PNS spleen kidney yang deficiency syndrome and normal control group.Differences in metabolism can be separated based on principal component analysis.Preliminary results from this study can be drawn that PNS spleen kidney yang deficiency syndrome has specific metabolic profiling on metabolomics levels,mainly related with lipids, amino acids,citric acid cycle and other metabolic disorders.In addition, the study also confirmed that there are great potential and advantages by means of metabolomic analysis in exploring TCM syndromes direction.But due to the research did not carry out the comparative metabolomics features study of PNS spleen kidney yang deficiency and the other PNS syndromes. Therefore, it is unable to judge the PNS spleen kidney yang deficiency syndrome from this study which belongs to the common factors of PNS,which belongs to the characteristic of PNS spleen kidney yang deficiency syndrome, which needs to be further improved in the future.