Changes and significance of serum energy metabolites in patients with pneumonia
Objective To investigate the changes of serum energy metabolites in patients with pneumonia and its prognostic value and clinical significance.Methods FTotally,50 patients with pneu-monia treated from September 2020 to September 2022 were selected as the study objects,and 50 healthy subjects were selected as the control group.The patients were divided into good prognosis group(29 cases)and bad prognosis group(21 cases).Peripheral blood was collected from the two groups,serum was sepa-rated,and metabolomics was used to analyze the changes of energy metabolism-related products in periph-eral blood of the patients.The changes of energy metabolites in patients with different prognosis and disease severity were compared.Multivariate Logistic regression was used to analyze the independent prognostic factors.The value of peripheral metabolite level in prognostic diagnosis was analyzed.Independent-Sample t test was used to compare measurement data between groups.Results The relative levels of lactic acid,glyceraldehyde 3-phosphate,dihydroxyacetone phosphate and phosphoenolpyruvate in peripheral blood of control group(1.29±0.25,1.74±0.57,1.15±0.27,1.14±0.28)were significantly lower than those of pneumonia group(4.61±1.17,3.46±0.77,2.50±0.53,2.66±0.81,t=19.570,12.630,16.190,12.600,P＜0.05).The acetyl CoA,citric acid,a-ketone glutaric acid relative levels of periph-eral blood in the control group(1.38±0.41,1.60±0.38,1.29±0.27)were significantly higher than pneumonia group(0.44±0.19,1.00±0.90,0.67±0.19)(t=14.610,8.918,13.170,P＜0.05).The relative level of ribulose-5 phosphate in peripheral blood of control group(1.42±0.21)was signifi-cantly higher than that of pneumonia group(0.62±0.21,t=19.110,P＜0.05).The relative levels of lactic acid,glyceraldehyde 3-phosphate,dihydroxyacetone phosphate and phosphoenolpyruvate in peripheral blood of patients in severe group and poor prognosis group(5.53±0.94,3.98±0.71,2.81±0.51,3.53±0.76;5.83±0.67,4.22±0.41,2.97±0.33,3.38±0.45)were significantly higher than mild and good prognosis group(3.68±0.39,2.94±0.39,2.20±0.34,2.04±0.33;3.74±0.38,2.91±0.41,2.16±0.34,2.14±0.56,t=9.040,6.344,4.999,9.218,P＜0.05;t=14.230,11.200,8.432,8.299,P＜0.05).Relative levels of acetyl-CoA,citric acid and a-ketoglutaric acid in peripheral blood of patients with severe and poor prognosis groups(0.38±0.12,0.80±0.25,0.57±0.15;0.32±0.12,0.71±0.12,0.55±0.17)were lower than that in mild group and good prognosis group(0.55±0.18,1.20±0.15,0.80±0.12;0.52±0.19,1.22±0.15,0.76±0.16,t=5.019,6.940,6.023,4.443,13.170,4.428,P＜0.05).The relative level of ribulose-5 phosphate in peripheral blood of pa-tients with severe disease and poor prognosis group(0.47±0.17,0.42±0.13)was significantly lower than that of mild disease and good prognosis group(0.78±0.12,0.77±0.12,t=97.097,9.851,P＜0.05).Lactic acid,phosphoenolpyruvate,CoA,citric acid,A-ketone glutaric acid were independent risk factors for the prognosis of patients with pneumonia[odds ratio(OR)=5.741,6.124,3.416,5.641,5.441,P＜0.05].Conclusion Abnormal serum glycolysis,tricarboxylic acid circulation and pentose phosphate pathway metabolism in patients with pneumonia are closely related to the disease and prognosis of patients with pneumonia.
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