| Objective Metabolic syndrome(MS)are a group of clinical syndromes with a combination of raised blood pressure,raised blood glucose,central obesity,raised triglycerides(TG)and reduced high-density lipoprotein cholesterol(HDL-C),which seriously affect the health of body.It is a combination of metabolically interrelated risk factors that directly contribute to the development of atherosclerotic cardiovascular disease and increase the risk of developing type 2 diabetes.In recent years,the prevalence of MS in China has increased significantly,and the prevalence of MS in the elderly population is significantly higher than that of the whole population.The Hongshuihe Basin in Guangxi is known as a long-lived area with an aging population higher than the average level in China and Guangxi during the same period,but no reports have been found on the prevalence characteristics of MS and its components in the elderly in the region and its impact on activity of daily living.In view of all above factors,this study first analyzed the prevalence of MS and its components in the elderly based on the Guangxi Hongshuihe Basin Elderly Health Cohort and its impact on activity of daily living,then explored the metabolic characteristics and differential metabolites of the MS components with the highest detection rate in this population using untargeted metabolomics,and finally validated the differential metabolites using targeted metabolomics.It will help to understand the prevalence of MS and its components in the elderly in the region and the metabolic characteristics of the main prevalent components,and provide a research basis for the prevention and control of MS and its components in the future.Method1.Using cross-sectional survey research method,elderly people aged 60-89 years in the Guangxi Hongshui River Basin Elderly Health Cohort were selected for study subjects.The detection rates and their discrepancy of MS and its components in two groups of older adults aged 60-74 years and 75-89 years were analyzed.The detection rates and their differences of MS and its components in older adults with different characteristics in each age group were computed.The detection rates and their variation of grip strength loss and impaired activity daily living in older adults with and without MS and its components were calculated.2.Using a case-control study approach.In the group of elderly aged 60-74 years,17 hypertensive patients were selected as hypertensive group.15 healthy older adults were selected as healthy control group with the matching condition of age ± 2 years and same sex.Conducted non-targeted metabolomic detection of plasma using chromatography mass spectrometry.Analyzed data using R language and KEGG online database.3.A case-control study was utilized.Internal validation population: in the group of elderly aged 60-74 years,20 hypertensive patients were selected as hypertensive group;20 healthy older adults were selected as healthy control group by age ± 2 years and same sex as 1:1 matching condition.External validation population: in elderly people aged 60-74 years from Lianhua Town,Gongcheng County,Guilin city,20 hypertensive patients were selected as hypertensive group,and 20 healthy elderly people were selected as healthy control group based on age ± 2 years and same sex as 1:1 matching condition.Conducted targeted quantification detection of 61 amino acids and their derivatives in plasma using chromatography mass spectrometry.performed analysis of data using R language,KEGG and Metaboanalyst online analysis tools.Results1.Prevalence characteristics of metabolic syndrome and its components and its impact on activity daily living(1)Prevalence of MS and its components: The detection rate of elderly aged 60-89 years was 8.72%.The detection rates of metabolic syndrome were9.20% and 7.29%,respectively(P=0.052).In 60-74 old group,the detection rates of raised blood pressure,raised TG,central obesity,raised blood glucose,and reduced HDL-C were 66.30%,19.27%,15.32%,8.93%,and 3.09%,respectively.In 75-89 old group,the detection rates of raised blood pressure,central obesity,raised TG,raised blood glucose,and reduced HDL-C were76.90%,14.92%,14.73%,9.63%,and 3.83%,respectively.There were statistically significant differences in detection rates of raised blood pressure and raised TG(P < 0.05)between older people aged 60-74 years and 75-89 years.(2)Influences of MS on activity of daily living: In both groups of older people,detection rates of grip strength loss in older adults with MS were lower than that in those without MS(P<0.05);detection rates of grip strength loss in older adults with central obesity were lower than that in those without central obesity(P<0.05);detection rates of grip strength loss in older adults with raised TG were lower than that in those with normal TG(P<0.05).In group of older people aged 60-74 years,the proportion of severely impaired overall activities of daily living in older adults with reduced HDL-C was higher than in those with normal HDL-C(P<0.001);the detection rate of physical activities of daily living in older adults with MS was higher than that in those without MS(P=0.046);the detection rate of physical activities of daily living in older adults with raised blood pressure was higher than that in those with normal blood pressure(P=0.046).In group of older people aged 75-89 years,the detection rate of physical activities of daily living in older adults with MS was higher than that in those without MS(P=0.042);detection rates of overall activities of daily living,physical activities of daily living and instrumental activities of daily living in elderly with reduced HDL-C were higher than that in those with normal HDL-C.2.Metabolic characteristics and screening for differential metabolites in hypertension(1)10 differential metabolites were found: L-lysine,3-methyl-histidine,2-phenylacetamide,uric acid and 3-hydroxyphenylacetic acid showed upward trend;L-histidine,2-oxohexanoic acid,β-hydroxybutyric acid,xanthine and carnitine showed downward trend.L-lysine,3-methyl-histidine and L-histidine belong to amino acids and their derivatives,with the largest percentage.(2)10 Differential metabolic pathways were found: Amino acid biosynthesis,histidine metabolism,lysine degradation,phenylalanine metabolism,ketone body synthesis and degradation,purine metabolism,adenosine triphosphate binding cassette transporter,protein digestion and absorption,Aminoacyl-t RNA biosynthesis.Specially,amino acids and their derivatives were involved in a total of six differential metabolic pathways.3.Validation of differential amino acids and their derivatives in hypertension(1)Validation of differential metabolites: There were no differences in plasma levels of L-histidine and L-lysine between the elderly hypertensive group and the healthy elderly in the total population,the internal validation population and the external validation population.(2)Newly identified differential amino acids and metabolic pathways:L-proline,L-asparagine and L-arginine were differential amino acids in the total,internal validation and external validation populations,with significantly upregulated.Arginine and proline metabolism,arginine biosynthesis,aminoacyl t RNA biosynthesis,and alanine,glutamate and aspartate metabolism were differential metabolic pathways.(3)Correlation between differential amino acids and clinical indices:L-proline was positively correlated with systolic and diastolic blood pressure.Conclusion1.The detection rate of MS in older adults in the Guangxi hongshuihe Basin is at a low level;raised blood pressure is the prevalent MS component in the elderly in the region;MS,central obesity,and raised TG were possible influencing factors for grip strength loss in the elderly;in older people aged60-74 years,HDL-C was a possible risk factor for impaired ADL,and MS and raised blood pressure were possible risk factors for impaired PADL;in elderly aged 75-89 years,MS was a possible risk factor for impaired PADL,and reduced HDL-C was a possible risk factor for impaired ADL,PADL and IADL.2.Metabolic disorders of elderly hypertensive patients may be dominated by disorders of amino acid metabolism.3.Elevated L-proline,L-asparagine and L-arginine may be characteristic of amino acid metabolism disorders in elderly hypertensive patients;L-proline was positively correlated with systolic and diastolic blood pressure. |
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