| Purpose: Aortic dissection(AD),as a critical cardiovascular disease with relatively complex clinical manifestations,high mortality and poor prognosis,has been increasing in recent years,its pathogenesis is still not fully understood.In order to better achieve early prevention and treatment,there is an urgent need for deeper research and understanding of the disease.Stanford type B aortic dissection(TBAD)is the dominant aortic dissection,with more than half of all TBAD patients having snoring.Therefore,it is promising to investigate the effect of Obstructive sleep apnea(OSA)on TBAD blood vessels.This study intends to explore the metabolic pattern and characteristics of AD patients by means of serum metabolomics,screen out specific metabolic targets,and further explore and verify them.At the same time,the pathogenesis or markers related to OSA syndrome and AD are sought from the perspective of metabolism,so as to better prevent,diagnose and treat AD.Methods: Clinical serum specimens of AD,obstructive sleep apnea(OSA)and normal volunteers were collected based on metabolomics techniques using gas chromatography-time of flight-mass spectrometry(GC-MS).Based on the metabolomics technique,we applied gas chromatography-time of flight-mass spectrometer(GC/TOF-MS)to detect metabolites in serum,and the raw data were processed and analyzed to obtain differential metabolic profiles and metabolic characteristics of serum from patients with aortic dissection,and to identify biomarkers that can be used for screening of high-risk groups.Patients with aortic dissection were then divided into combined OSA and non-combined OSA groups according to whether they had obstructive sleep apnea(OSA)or not and further validated the role of OSA in the development of aortic dissection.Results: The serum metabolomics histology results showed that 98 differential metabolites were screened in all TBAD patients against healthy patients,including 41up-regulated metabolites and 57 down-regulated metabolites,and the differential metabolites were mainly related to central carbon metabolism(aminyl t RNA biosynthesis,alanine,aspartate,glutamate metabolism,ATP-binding transporter protein,tricarboxylic acid cycle,purine metabolism,arginine biosynthesis,galactose metabolic pathway).Further,the serum metabolomics results were combined with the serum metabolomics results to screen for methyl-ornithine,2,4-diaminobutyric acid and5,7-dihydroxy-4’-methoxyisoflavone as screening indicators for TBAD in patients with combined OSA.The diagnostic efficacy of the three indicators in the high-risk population(those with OSA)was 0.765(95% CI: 0.638-0.893,P = 0.001),0.976(95%CI: 0.946-1.000,P < 0.001)and 0.840(95% CI:0.733-0.948,P < 0.001),respectively.0.001).Conclusion: We applied serum metabolomics for the first time to study metabolic alterations in the serum of patients with aortic dissection and obtained a differential spectrum of serum metabolites and their metabolic profiles in patients with aortic dissection,suggesting that patients with aortic dissection may have central carbon metabolism,purine metabolism,arginine biosynthesis,galactose metabolism,etc.This provides a new target and direction for further study of the mechanism of aortic dissection from the perspective of metabolism.The metabolic disorders of differential metabolites in patients with aortic dissection suggest the possibility of in vitro monitoring of differential metabolite levels as a risk warning and marker of aortic dissection,and its protective effect and interventional properties on aortic dissection are expected to be new targets for the prevention of aortic dissection and disease treatment;Methyl-ornithine,2,4-diaminobutyric acid and 5,7-diaminobutyric acid are also expected to be new targets for the prevention of aortic dissection and disease treatment.Methyl-ornithine,2,4-diaminobutyric acid and 5,7-dihydroxy-4’-methoxyisoflavone can be used as screening indicators for people with high risk of TBAD(combined OSA patients). |
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