Non-targeted Metabolomics Study Of Serum In Patients With Stable Angina Pectoris (spleen Deficiency And Phlegm Turbidity Syndrome

Purpose:In this study,liquid chromatography and mass spectrometry were used to explore the difference between patients with stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbidity syndrome and healthy people from the perspective of non-targeted metabolomics.The changes of metabolites in patients with stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbidity syndrome were clarified,and the intrinsic pathological state of syndromes in patients with stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbidity syndrome was revealed.In order to put forward a new method for early diagnosis and treatment of stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbidity syndrome,so as to give full play to the role of TCM syndrome differentiation and treatment,and bring the gospel to more patients with stable angina pectoris of coronary heart disease.Material and method:From October 2021 to December 2021,60 patients with stable angina pectoris of coronary heart disease were selected as the experimental group,and 60 healthy people were recruited as the control group.The serum metabolomics of the two groups of subjects was detected by liquid chromatography and mass spectrometry.The principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA)were used to observe the differences in the distribution of metabolites between groups,and the enrichment analysis and topological analysis of the pathways where the differential metabolites were located were carried out to find the key pathways with the highest correlation with the differences in metabolites.To further reveal the molecular mechanism of metabolic disorder caused by spleen deficiency and phlegm turbidity syndrome in stable angina pectoris of coronary heart disease.Results:1.According to the screening results of differential metabolites,33 kinds of differential metabolites were identified,of which 22 small molecule metabolites were significantly increased in the CHD group with spleen deficiency and phlegm turbidity.They are oleic acid amide,s-sulfo-l-cysteine,α-solanine,taurine,2-mercaptobenzothiazole,l-gamma-glutamyl-l-hypoglycin,octanoic acid,octaacyl glucuronic acid,porphobilinogen,stearic acid,cyclohexanecarboxylic acid,L-tyrosine,2-propylglutaric acid,sulcatone,solanine,gabapentin,soyasaponin II,dibutyl phthalate,8-amino-7-oxononanoate,arecoline,melatonin and carsiamide;eleven small molecule metabolites were significantly decreased in the CHD group with spleen deficiency and phlegm turbidity,which were soybean saponin III,2-dehydro-d-gluconate,(+ /-)-6-hydroxy-3-oxo-alpha-ionone,diethyl phosphate,cascarillin,guanosine,5-(2-ethyl)-4-methylthiazole,(r)-acetoin,phenylacetaldehyde,guanine,and orthophosphate,respectively.2.HMDB classification of 33 differential metabolites mainly focused on lipids and lipid molecules,organic acids and their derivatives,organic heterocyclic compounds,organic oxygen compounds,benzene ring compounds,nucleosides,nucleotides and analogues,homogeneous nonmetallic compounds,alkaloids and their derivatives,organic nitrogen compounds,phenylpropanoids and polyketides.3.The three metabolic pathways with the highest correlation for enrichment analysis of differential metabolites KEGG were thiamine metabolism,purine metabolism and phenylalanine metabolism.Conclusion:1.A total of 33 differential metabolites were identified in this study.Among them,the four most noteworthy differential metabolites in the diagnosis and treatment of coronary heart disease with spleen deficiency and phlegm turbidity syndrome were oleic acidamide,melatonin,dibutyl phthalate and soybean saponin;after HMDB classification,33 differential metabolites were mainly concentrated in four categories : lipids and lipid molecules,organic acids and their derivatives,organic heterocyclic compounds,and benzene ring compounds.The abnormal changes of these differential metabolites suggest that there may be abnormalities in thiamine metabolism,purine metabolism and phenylalanine metabolism in patients with coronary heart disease with spleen deficiency and phlegm turbidity syndrome.2.There are significant differences in serum metabolites between patients with stable angina pectoris of coronary heart disease with spleen deficiency and phlegm turbidity syndrome and healthy people.It is feasible to apply non-target metabolomics technology to study TCM syndromes of coronary heart disease.