A Pilot Metabolic Profiling Study of Patients With Neonatal Jaundice and Response to Phototherapy

Cai, Aizhen; Qi, Suwen; Su, Ziyi; Shen, He; Yang, Yajun; Cai, Wanru; Dai, Yong

doi:10.1111/cts.12401

Cited by 13 publications

(19 citation statements)

References 17 publications

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“…Other potentially relevant etiologic underpinnings are suggested by the patterns we observed for leucine and free carnitine. Elevated levels of leucine and isoleucine are consistent with abnormal metabolism of amino acids among infants with hyperbilirubinemia, and have been observed previously in term infants . However, in the present study, decreased levels of leucine were seen in infants ≥ 34 weeks GA. Low levels of isoleucine and leucine are associated with malnutrition .…”

Section: Discussionmentioning

confidence: 99%

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Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

McCarthy

Oltman

Baer

et al. 2018

Clinical Translational Sci

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Our objective was to assess the relationship between hyperbilirubinemia with and without kernicterus and metabolic profile at newborn screening. Included were 1,693,658 infants divided into a training or testing subset in a ratio of 3:1. Forty‐two metabolites were analyzed using logistic regression (odds ratios (ORs), area under the receiver operating characteristic curve (AUC), 95% confidence intervals (CIs)). Several metabolite patterns remained consistent across gestational age groups for hyperbilirubinemia without kernicterus. Thyroid stimulating hormone (TSH) and C‐18:2 were decreased, whereas tyrosine and C‐3 were increased in infants across groupings. Increased C‐3 was also observed for kernicterus (OR: 3.17; 95% CI: 1.18–8.53). Thirty‐one metabolites were associated with hyperbilirubinemia without kernicterus in the training set. Phenylalanine (OR: 1.91; 95% CI: 1.85–1.97), ornithine (OR: 0.76; 95% 0.74–0.77), and isoleucine + leucine (OR: 0.63; 95% CI: 0.61–0.65) were the most strongly associated. This study showed that newborn metabolic function is associated with hyperbilirubinemia with and without kernicterus.

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Section: Discussionmentioning

confidence: 99%

“…Hyperbilirubinemia (jaundice) is one of the most common conditions in the first weeks of life, occurring in 60% of term infants and 80% of preterm infants . Although some degree of hyperbilirubinemia is often benign in newborns, significant unconjugated hyperbilirubinemia may have adverse consequences.…”

mentioning

confidence: 99%

Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

McCarthy

Oltman

Baer

et al. 2018

Clinical Translational Sci

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“…Phototherapy is widely used, and blue light therapy is currently employed to treat neonatal jaundice in the majority of countries, including China. Blue light is employed mainly because bilirubin absorbs light, particularly on the blue part of the spectrum, near the main wavelength peak of 460 nm ( 40 , 41 ); in addition, compared with green and ultraviolet (UV) light, bilirubin molecules absorb blue light more readily ( 3 ). Furthermore, although UV light accounts for a small proportion (~0.3%) of the traditional blue-green phototherapy, when the skin is exposed to UV light, the pro-inflammatory pathway of the skin's immune system is activated, which increases the production of inflammatory factors and triggers an autoimmune response.…”

Section: Neonatal Hyperbilirubinemiamentioning

confidence: 99%

Challenges of phototherapy for neonatal hyperbilirubinemia (Review)

Juan

Guo

et al. 2021

Exp Ther Med

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Phototherapy is universally recognized as the first option for treating neonatal jaundice due to its unparalleled efficiency and safety in reducing the high serum free bilirubin levels and limiting its neurotoxic effects. However, several studies have suggested that phototherapy may elicit a series of short- and long-term adverse reactions associated with pediatric diseases, including hemolysis, allergic diseases, DNA damage or even cancer. The aim of the present review was to summarize the etiology, mechanism, associated risks and therapeutic strategies for reducing high neonatal serum bilirubin levels. In order to shed light on the negative effects of phototherapy and to encourage implementation of a reasonable and standardized phototherapy scheme in the clinic, the present review sought to highlight the current understanding of the adverse reactions of phototherapy, as it is necessary to further study the mechanism underlying the development of the adverse effects of phototherapy in infants in order to explore novel therapeutic alternatives.

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“…The statistically significant metabolites were then analyzed and summarized by calculating the corresponding correlation coefficients, as previously described. 21 Briefly, we multiplied the loading value with the square root of its SD, which was compared with the Corresponding Correlation Coefficient Critical Value Table. The metabolites that had significantly different levels between the groups were identified.…”

Section: Principal Component Analysis and Orthogonal Partial Least Sqmentioning

confidence: 99%

Serum Metabolomic Profiles Associated With Untreated Metabolic Syndrome Patients in the Chinese Population

Wang

Zhuang

et al. 2020

Clinical Translational Sci

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Metabolomics is a promising technology for elucidating the mechanisms of metabolic syndrome (MetS). However, measurements in patients with MetS under different conditions vary. Metabolomics experiments in different populations and pathophysiological conditions are, therefore, indispensable. We performed a serum metabolomics investigation in untreated patients with MetS in the Chinese population. Untreated patients with MetS were recruited to this study. Metabolites were measured using a traditional 1H nuclear magnetic resonance (NMR) experiment followed by principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS‐DA). Key metabolic pathways were identified by searching the Kyoto Encyclopedia of Genes and Genomes Pathway Database. A total of 28 patients with MetS and 30 healthy subjects were enrolled. All patients were untreated because they were unaware of or neglected to treat their MetS. By 1H NMR, we identified 49 known substances. Following PCA and OPLS‐DA, 36 metabolites were confirmed to be closely associated with MetS compared with the control group; 33 metabolites were increased, whereas 3 metabolites were reduced. Importantly, 14 metabolites that changed in the serum of these untreated patients with MetS were previously unreported. Pathway analysis revealed the top 15 metabolic pathways associated with untreated MetS, which included 3 amino acid metabolic pathways. Our data suggest that untreated patients exhibit a worse pathophysiologic manifestation, which may result in more rapid progression of MetS. Thus, we propose that health education be reinforced to improve the public’s knowledge, attitude, and practice regarding MetS. The rates of “untreated” patients due to unawareness and neglect must be reduced immediately.

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A Pilot Metabolic Profiling Study of Patients With Neonatal Jaundice and Response to Phototherapy

Cited by 13 publications

References 17 publications

Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

Newborn Metabolic Profile Associated with Hyperbilirubinemia With and Without Kernicterus

Challenges of phototherapy for neonatal hyperbilirubinemia (Review)

Serum Metabolomic Profiles Associated With Untreated Metabolic Syndrome Patients in the Chinese Population

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