Study On Serum Metabonomics Of Patients With Stable Angina Pectoris Of Spleen Deficiency And Phlegm Turbidity Syndrome

Objective: Through the use of metabolomics to seek the serum metabolic markers of CAD(coronary artery disease)patients with spleen deficiency and turbid phlegm syndrome.Methods: A total of 30 CAD patients with spleen deficiency and turbid phlegm syndrome who visited our 6 field centers from June 2013 to December 2014 were included in this study as the experimental group and meanwhile,another 30 health persons were recruited as the control group.Serum metabolomic analysis was performed on both groups with the liquid chromatography–mass spectrometry(LC-MS)technology.The principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA)were used to observe the difference in metabolite distribution between the groups.In addition,the VIP scores of the first two principal components in the multivariate PLS-DA model,as well as the fold-change and p-value in the univariate analysis were also used to screen differentially expressed metabolites.Screening conditions were as follows:(1)VIP?1;(2)fold-change?1.2 or?0.8333;(3)P<0.05.The shared ions,namely the differential ions,were obtained from the intersection of the three.Finally,gene set enrichment analysis and topological data analysis were performed on the pathways of differential metabolites to find the key pathways most associated with the differences of metabolites.Results: The experimental group and the healthy control group could be clearly distinguished on the PCA and PLS-DA graphs for pattern recognition,and the PLS-DA model was highly reliable.A total of 26 differential metabolites were identified in the two groups.Among them,the experimental group had a higher level of leucine,histidine,vitamin A,phytosphingosine,sphingosine,L-carnitine and a lower level of hypoxanthine,inosine,arabinosylhypoxanthine,riboflavin,deoxyadenosine,arginine,bilirubin,biliverdin,2-phenylaminoadenosine,all-trans-5,6-epoxyretinoic acid,alpha-linolenic acid,docosahexaenoic acid,alpha-dimorphecolic acid,3b,5a,6b-cholestanetriol,lysophosphatidylcholine(6:0),glutaminyl-glutamate,9-decenoylcarnitine,alpha-linolenyl carnitine,2-octenoylcarnitine,lipoyl-AMP than the healthy control group.Four key pathways that were most associated with the differences of metabolites were retinol metabolism,lipoicacid metabolism,riboflavin metabolism and alpha-linolenic acid metabolism?Conclusion: Differences were found in various serum metabolites between CAD patients with spleen deficiency and turbid phlegm syndrome and healthy controls.The abnormal changes of these metabolites suggest that there may be disorders of lipid,amino acid,vitamin,purine and other metabolic pathways in patients.Metabonomics can be used to explore the pathological state of patients with spleen deficiency and phlegm turbidity syndrome of coronary heart disease and provide a basis for the modern scientific connotation and accurate identification of traditional Chinese medicine syndromes.