Article(id=1241319155106894582, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241319148798669160, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202501167, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736438400000, receivedDateStr=2025-01-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773883149172, onlineDateStr=2026-03-19, pubDate=1750780800000, pubDateStr=2025-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773883149172, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773883149172, creator=13701087609, updateTime=1773883149172, updator=13701087609, issue=Issue{id=1241319148798669160, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='12', pageStart='2113', pageEnd='2304', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773883147667, creator=13701087609, updateTime=1773885555254, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241329247004971040, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241319148798669160, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241329247004971041, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241319148798669160, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2179, endPage=2185, ext={EN=ArticleExt(id=1241319155501159188, articleId=1241319155106894582, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the metabolic characteristics of vitamin D deficiency in children and adolescents based on non-targeted metabolomics, columnId=1228016572783063333, journalTitle=Modern Preventive Medicine, columnName=Nutrition and Food Hygiene, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the metabolic characteristics and potential biomarkers of vitamin D deficiency in children and adolescents, and to provide a basis for early identification and prevention of vitamin D deficiency.

Methods

Sixty pairs of children and adolescents with vitamin D deficiency and normal levels (matched by age and gender) from the nutrition and health monitoring project of rural school-age children in Guangzhou from March to May 2023 were selected as the research subjects. Based on the determination of serum 25(OH)D and serum untargeted metabolomics, differentially expressed metabolites (set threshold: FC value >1.25 or <0.8, VIP value >1) were screened, and metabolic pathways were analyzed. Logistic regression was applied to screen potential biomarkers, and ROC curves were drawn to evaluate their accuracy.

Results

56 differentially expressed metabolites (38 up-regulated and 18 down-regulated) were identified. The analysis of metabolic pathways showed that the steroid hormone biosynthesis pathway was statistically significant(P=0.001, QFDR=0.0982). Logistic regression analysis results showed that 12 potential biomarkers such as 7,8-epoxy-4Z,10Z,13Z,16Z,19Z-(OR=1.95, 95% CI: 1.20-3.17) had statistical significance in the association with vitamin D deficiency, and the AUC in the training set was 0.922(95% CI: 0.865-0.978), and in the test set was 0.910 (95% CI: 0.809-1), with high accuracy.

Conclusion

This study revealed the metabolic pathways related to vitamin D deficiency in children and adolescents and identified 12 potential biomarkers, providing a basis for clarifying the metabolic characteristics and carrying out early identification of vitamin D deficiency.

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目的

探索儿童青少年血清维生素D缺乏的代谢特征及潜在生物标志物,为开展维生素D缺乏的早期识别和防控提供依据。

方法

选取2023年3—5月广州市农村学龄儿童营养健康监测项目中60对维生素D缺乏和正常儿童青少年(年龄和性别匹配)作为研究对象。结合血清25(OH)D测定和血清非靶向代谢组学,筛选差异代谢物(设置阈值:FC值>1.25或<0.8,VIP值>1)并分析代谢通路。应用logistic回归筛选潜在生物标志物,并绘制ROC曲线以评估其准确性。

结果

筛选出56个差异代谢物(38个上调,18个下调)。代谢通路分析显示,类固醇激素生物合成通路具有统计学意义 (P=0.001, QFDR=0.098 2)。Logistic回归分析结果显示,7,8-环氧基-4Z,10Z,13Z,16Z,19Z-(OR=1.95,95% CI:1.20~3.17)等12种潜在生物标志物与维生素D缺乏情况的关联具有统计学意义,且在训练集中AUC=0.922,95% CI: 0.865~0.978,在测试集中AUC =0.910,95% CI: 0.809~1,准确性较高。

结论

本研究揭示了儿童青少年维生素D缺乏相关的代谢通路,识别出12种潜在生物标志物,为阐明维生素D缺乏的代谢特征及开展早期识别提供了基础。

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黄婕与李燕为共同通信作者。黄婕,E-mail:
李燕,E-mail:
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钟婉珍(1999—),女,硕士在读,研究方向:营养流行病学

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(In Chinese), articleTitle=Analysis of serum 25-hydroxyvitamin D and sex hormone levels in children with central precocious puberty, refAbstract=null), Reference(id=1241319173670883868, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=1, pageStart=59, pageEnd=63, url=null, language=null, rfNumber=[33], rfOrder=38, authorNames=刘小琪, 王琨蒂, 王君, journalName=中国儿童保健杂志, refType=null, unstructuredReference=刘小琪,王琨蒂,王君,等.维生素D缺乏与儿童中枢性性早熟关系研究进展[J].中国儿童保健杂志2024,32(1):59-63., articleTitle=维生素D缺乏与儿童中枢性性早熟关系研究进展, refAbstract=null), Reference(id=1241319173792518691, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=1, pageStart=59, pageEnd=63, url=null, language=null, rfNumber=[33], rfOrder=39, authorNames=Liu XQ, Wang KD, Wang J, journalName=Chinese Journal of Child Health Care, refType=null, unstructuredReference=Liu XQ, Wang KD, Wang J, et al. 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(In Chinese), articleTitle=Research progress in the relationship between vitamin D deficiency and central precocious puberty in children, refAbstract=null)], funds=[Fund(id=1241319167815635296, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, awardId=2023A03J0940, language=CN, fundingSource=广州市科技计划项目(2023A03J0940), fundOrder=null, country=null), Fund(id=1241319167920492900, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, awardId=2023A03J0451, language=CN, fundingSource=广州市科技计划项目(2023A03J0451), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241319158923711411, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, xref=1., ext=[AuthorCompanyExt(id=1241319158932100020, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, companyId=1241319158923711411, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China), AuthorCompanyExt(id=1241319158940488630, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, companyId=1241319158923711411, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.中山大学公共卫生学院,广东 广州 510080)]), AuthorCompany(id=1241319159041151935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, xref=2., ext=[AuthorCompanyExt(id=1241319159049540545, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, companyId=1241319159041151935, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广州市疾病预防控制中心(广州市卫生监督所)食品安全与营养部)])], figs=[ArticleFig(id=1241319164598604028, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Fig.1, caption=Score plot and permutation test plot of the OPLS-DA, figureFileSmall=GPgs2X+T0zHR6hdhhbUQmQ==, figureFileBig=vOQOn//B6yE+hcqv/WqKuQ==, tableContent=null), ArticleFig(id=1241319164711850242, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=图1, caption=OPLS-DA模型评分图及置换检验图

注:A为OPLS-DA模型评分图,B为OPLS-DA模型置换检验图。

, figureFileSmall=GPgs2X+T0zHR6hdhhbUQmQ==, figureFileBig=vOQOn//B6yE+hcqv/WqKuQ==, tableContent=null), ArticleFig(id=1241319164959314198, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Fig.2, caption=Differential metabolites KEGG pathway analysis, figureFileSmall=kraxaObiDHPk2cx/4aIqaw==, figureFileBig=RHUuPHPudOOe6xl48OPiJQ==, tableContent=null), ArticleFig(id=1241319165039005980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=图2, caption=差异代谢物KEGG通路富集图, figureFileSmall=kraxaObiDHPk2cx/4aIqaw==, figureFileBig=RHUuPHPudOOe6xl48OPiJQ==, tableContent=null), ArticleFig(id=1241319166553149732, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Fig.3, caption=Location annotation diagram of differential metabolites in the steroid hormone biosynthesis pathway, figureFileSmall=anx/t6jXWrAbag+4a7N3lw==, figureFileBig=x/WdFLQf1hEI5/UnFkfffg==, tableContent=null), ArticleFig(id=1241319166691561771, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=图3, caption=差异代谢物在类固醇激素生物合成通路的位置标注图

注:C00523为雄酮、C03917为二氢睾酮、C04373为雄甾烷醇酮、C00535为睾酮、C02538为雌酮3-硫酸盐;红色代表差异代谢物在维生素D缺乏组中为较高的强度。

, figureFileSmall=anx/t6jXWrAbag+4a7N3lw==, figureFileBig=x/WdFLQf1hEI5/UnFkfffg==, tableContent=null), ArticleFig(id=1241319166825779504, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Fig.4, caption=ROC curve analysis of 12 metabolites based on logistic regression, figureFileSmall=B4Vi2SDRJCdWpZBmANeHpQ==, figureFileBig=DIHRCJGi6RWyHgF/JUqiMg==, tableContent=null), ArticleFig(id=1241319166922248502, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=图4, caption=基于logistic回归的12种代谢物的 ROC 曲线分析

注:A为训练集ROC曲线;B为测试集ROC曲线。

, figureFileSmall=B4Vi2SDRJCdWpZBmANeHpQ==, figureFileBig=DIHRCJGi6RWyHgF/JUqiMg==, tableContent=null), ArticleFig(id=1241319167039689021, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Tabel 1, caption=

The basic information of children and adolescents in two group with normal and deficient vitamin D levels

, figureFileSmall=null, figureFileBig=null, tableContent=
基本情况维生素D正常组维生素D缺乏组Z值/χ2P
年龄(岁)[M(P25,P75)]13.80(13.13,14.50)14.00(12.27,14.61)-0.3810.704
性别[n(%)]0.0001.000
36(60.00)36(60.00)
24(40.00)24(40.00)
户外活动时间(min)[M(P25,P75)]210.00(127.50,337.50)150.00(90.00,262.50)-2.4820.013
过去一周维生素D营养补充剂使用行为[n(%)]2.6360.104
15(25.00)8(13.30)
45(75.00)52(86.70)
BMI z评分[M(P25,P75)]1.07(-0.55,2.08)0.09(-0.54,1.58)-1.6900.091
), ArticleFig(id=1241319167169712452, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=表1, caption=

维生素D正常组和缺乏组儿童青少年的基本情况

, figureFileSmall=null, figureFileBig=null, tableContent=
基本情况维生素D正常组维生素D缺乏组Z值/χ2P
年龄(岁)[M(P25,P75)]13.80(13.13,14.50)14.00(12.27,14.61)-0.3810.704
性别[n(%)]0.0001.000
36(60.00)36(60.00)
24(40.00)24(40.00)
户外活动时间(min)[M(P25,P75)]210.00(127.50,337.50)150.00(90.00,262.50)-2.4820.013
过去一周维生素D营养补充剂使用行为[n(%)]2.6360.104
15(25.00)8(13.30)
45(75.00)52(86.70)
BMI z评分[M(P25,P75)]1.07(-0.55,2.08)0.09(-0.54,1.58)-1.6900.091
), ArticleFig(id=1241319167291347275, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Tabel 2, caption=

The top 10 serum differential metabolites ranked by VIP values

, figureFileSmall=null, figureFileBig=null, tableContent=
序号差异代谢物FC值VIP值变化趋势
19-芴醇18.487.40
2鸟苷36.837.20
3(±)4-羟基-5E,7Z,10Z,13Z,16Z,19Z-二十二碳六烯酸0.027.02
43,4-二甲氧基苯乙酸0.672.93
53-羧基-4-甲基-5-丙基-2-呋喃丙酸0.532.90
6双(1L-肌醇)-3,1’-磷酸1-磷酸1.702.80
7肉碱 C5:10.782.72
8生物素酰胺0.782.58
9肌酸0.772.42
10丝氨酸-苯丙氨酸-丙氨酸0.792.26
), ArticleFig(id=1241319167392010573, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=表2, caption=

VIP值排名前10的差异代谢物

, figureFileSmall=null, figureFileBig=null, tableContent=
序号差异代谢物FC值VIP值变化趋势
19-芴醇18.487.40
2鸟苷36.837.20
3(±)4-羟基-5E,7Z,10Z,13Z,16Z,19Z-二十二碳六烯酸0.027.02
43,4-二甲氧基苯乙酸0.672.93
53-羧基-4-甲基-5-丙基-2-呋喃丙酸0.532.90
6双(1L-肌醇)-3,1’-磷酸1-磷酸1.702.80
7肉碱 C5:10.782.72
8生物素酰胺0.782.58
9肌酸0.772.42
10丝氨酸-苯丙氨酸-丙氨酸0.792.26
), ArticleFig(id=1241319167551394131, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=EN, label=Table 3, caption=

The logistic regression analysis results of potential biomarkers and the risk of vitamin D deficiency

, figureFileSmall=null, figureFileBig=null, tableContent=
种类潜在生物标志物OR值(95% CIPQFDR
脂肪酰类7,8-环氧基-4Z,10Z,13Z,16Z,19Z-1.95(1.20~3.17)0.0060.037
11-羟基-12E,14Z-二十碳二烯酸1.87(1.18~2.97)0.0070.037
12-羟基-5,8,10-十七碳三烯酸1.87(1.19~2.94)0.0070.037
16,16-二甲基前列腺素A22.11(1.29~3.46)0.0030.037
肉碱 C5:10.55(0.35~0.86)0.0090.037
氨基酸及其代谢物L-胱氨酸1.92(1.19~3.10)0.0070.037
丝氨酸-苯丙氨酸-丙氨酸0.53(0.34~0.83)0.0050.037
激素及激素相关物质11-β-羟基雄酮1.89(1.21~2.94)0.0050.037
苯及其衍生物3,4-二甲氧基苯乙酸0.38(0.22~0.65)0.0010.023
杂环化合物4-羟基-4-(吡啶-2-基)丁-2-酮2.04(1.20~3.48)0.0080.037
醇、胺类双(1L-肌醇)-3,1’-磷酸1-磷酸2.27(1.37~3.76)0.0020.028
有机酸及其衍生物3-羧基-4-甲基-5-丙基-2-呋喃丙酸0.44(0.27~0.72)0.0010.026
), ArticleFig(id=1241319167673028952, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241319155106894582, language=CN, label=表3, caption=

潜在生物标志物与维生素D缺乏风险的logistic回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
种类潜在生物标志物OR值(95% CIPQFDR
脂肪酰类7,8-环氧基-4Z,10Z,13Z,16Z,19Z-1.95(1.20~3.17)0.0060.037
11-羟基-12E,14Z-二十碳二烯酸1.87(1.18~2.97)0.0070.037
12-羟基-5,8,10-十七碳三烯酸1.87(1.19~2.94)0.0070.037
16,16-二甲基前列腺素A22.11(1.29~3.46)0.0030.037
肉碱 C5:10.55(0.35~0.86)0.0090.037
氨基酸及其代谢物L-胱氨酸1.92(1.19~3.10)0.0070.037
丝氨酸-苯丙氨酸-丙氨酸0.53(0.34~0.83)0.0050.037
激素及激素相关物质11-β-羟基雄酮1.89(1.21~2.94)0.0050.037
苯及其衍生物3,4-二甲氧基苯乙酸0.38(0.22~0.65)0.0010.023
杂环化合物4-羟基-4-(吡啶-2-基)丁-2-酮2.04(1.20~3.48)0.0080.037
醇、胺类双(1L-肌醇)-3,1’-磷酸1-磷酸2.27(1.37~3.76)0.0020.028
有机酸及其衍生物3-羧基-4-甲基-5-丙基-2-呋喃丙酸0.44(0.27~0.72)0.0010.026
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基于非靶向代谢组学探讨儿童青少年维生素D缺乏的代谢特征
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钟婉珍 1, 2 , 骆诗韵 2 , 万家怡 1, 2 , 陶桂贤 1, 2 , 曾淳子 2 , 张维蔚 2 , 黄婕 2 , 李燕 1, 2
现代预防医学 | 营养与食品卫生 2025,52(12): 2179-2185
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现代预防医学 | 营养与食品卫生 2025, 52(12): 2179-2185
基于非靶向代谢组学探讨儿童青少年维生素D缺乏的代谢特征
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钟婉珍1, 2, 骆诗韵2, 万家怡1, 2, 陶桂贤1, 2, 曾淳子2, 张维蔚2, 黄婕2 , 李燕1, 2
作者信息
  • 1.中山大学公共卫生学院,广东 广州 510080
  • 2.广州市疾病预防控制中心(广州市卫生监督所)食品安全与营养部
  • 钟婉珍(1999—),女,硕士在读,研究方向:营养流行病学

通讯作者:

黄婕与李燕为共同通信作者。黄婕,E-mail:
李燕,E-mail:
Study on the metabolic characteristics of vitamin D deficiency in children and adolescents based on non-targeted metabolomics
Wan-zhen ZHONG1, 2, Shi-yun LUO2, Jia-yi WAN1, 2, Gui-xian TAO1, 2, Chun-zi ZENG2, Wei-wei ZHANG2, Jie HUANG2 , Yan LI1, 2
Affiliations
  • School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
出版时间: 2025-06-25 doi: 10.20043/j.cnki.MPM.202501167
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目的

探索儿童青少年血清维生素D缺乏的代谢特征及潜在生物标志物,为开展维生素D缺乏的早期识别和防控提供依据。

方法

选取2023年3—5月广州市农村学龄儿童营养健康监测项目中60对维生素D缺乏和正常儿童青少年(年龄和性别匹配)作为研究对象。结合血清25(OH)D测定和血清非靶向代谢组学,筛选差异代谢物(设置阈值:FC值>1.25或<0.8,VIP值>1)并分析代谢通路。应用logistic回归筛选潜在生物标志物,并绘制ROC曲线以评估其准确性。

结果

筛选出56个差异代谢物(38个上调,18个下调)。代谢通路分析显示,类固醇激素生物合成通路具有统计学意义 (P=0.001, QFDR=0.098 2)。Logistic回归分析结果显示,7,8-环氧基-4Z,10Z,13Z,16Z,19Z-(OR=1.95,95% CI:1.20~3.17)等12种潜在生物标志物与维生素D缺乏情况的关联具有统计学意义,且在训练集中AUC=0.922,95% CI: 0.865~0.978,在测试集中AUC =0.910,95% CI: 0.809~1,准确性较高。

结论

本研究揭示了儿童青少年维生素D缺乏相关的代谢通路,识别出12种潜在生物标志物,为阐明维生素D缺乏的代谢特征及开展早期识别提供了基础。

维生素D缺乏  /  儿童青少年  /  非靶向代谢组学
Objective

To explore the metabolic characteristics and potential biomarkers of vitamin D deficiency in children and adolescents, and to provide a basis for early identification and prevention of vitamin D deficiency.

Methods

Sixty pairs of children and adolescents with vitamin D deficiency and normal levels (matched by age and gender) from the nutrition and health monitoring project of rural school-age children in Guangzhou from March to May 2023 were selected as the research subjects. Based on the determination of serum 25(OH)D and serum untargeted metabolomics, differentially expressed metabolites (set threshold: FC value >1.25 or <0.8, VIP value >1) were screened, and metabolic pathways were analyzed. Logistic regression was applied to screen potential biomarkers, and ROC curves were drawn to evaluate their accuracy.

Results

56 differentially expressed metabolites (38 up-regulated and 18 down-regulated) were identified. The analysis of metabolic pathways showed that the steroid hormone biosynthesis pathway was statistically significant(P=0.001, QFDR=0.0982). Logistic regression analysis results showed that 12 potential biomarkers such as 7,8-epoxy-4Z,10Z,13Z,16Z,19Z-(OR=1.95, 95% CI: 1.20-3.17) had statistical significance in the association with vitamin D deficiency, and the AUC in the training set was 0.922(95% CI: 0.865-0.978), and in the test set was 0.910 (95% CI: 0.809-1), with high accuracy.

Conclusion

This study revealed the metabolic pathways related to vitamin D deficiency in children and adolescents and identified 12 potential biomarkers, providing a basis for clarifying the metabolic characteristics and carrying out early identification of vitamin D deficiency.

Vitamin D deficiency  /  Children and adolescents  /  Non-targeted metabolomics
钟婉珍, 骆诗韵, 万家怡, 陶桂贤, 曾淳子, 张维蔚, 黄婕, 李燕. 基于非靶向代谢组学探讨儿童青少年维生素D缺乏的代谢特征. 现代预防医学, 2025 , 52 (12) : 2179 -2185 . DOI: 10.20043/j.cnki.MPM.202501167
Wan-zhen ZHONG, Shi-yun LUO, Jia-yi WAN, Gui-xian TAO, Chun-zi ZENG, Wei-wei ZHANG, Jie HUANG, Yan LI. Study on the metabolic characteristics of vitamin D deficiency in children and adolescents based on non-targeted metabolomics[J]. Modern Preventive Medicine, 2025 , 52 (12) : 2179 -2185 . DOI: 10.20043/j.cnki.MPM.202501167
维生素D对儿童青少年的骨骼健康和心血管健康等至关重要[1]。全球范围内,儿童青少年普遍存在维生素D缺乏或不足的问题[2-3]。我国情况也日益严峻,2015—2018年儿童青少年维生素D缺乏率较2011—2014年有所上升[4]。广州作为华南地区的代表城市,7~18岁儿童青少年维生素D缺乏率为7.5%,不足率为44.4% [5],而农村地区9~16岁儿童青少年维生素D缺乏和不足率分别为13.43%和46.63%[6],高于上述广州市平均水平。
当前,血清25-羟基维生素D(25(OH)D)被认为是评估维生素D营养状态的最佳指标[7],但其高稳定性和较长的半衰期限制了对维生素D缺乏的识别能力。非靶向代谢组学作为一种分析技术,可检测样本中的代谢成分,常用于探索新的生物标志物和研究疾病发病机制[8],已在孕产妇和老年人群体中被证明是研究维生素D缺乏代谢特征的有力工具[9-11]
本研究结合血清25(OH)D测定和血清非靶向代谢组学方法,以广州市农村地区儿童青少年为研究对象,旨在探索维生素D缺乏相关的代谢差异并筛选潜在生物标志物,为阐明儿童青少年维生素D缺乏的代谢特征及开展早期识别提供可靠依据。
本研究基于2023年3—5月广州市农村学龄儿童营养健康监测项目[6]。根据《人群维生素D缺乏筛查方法》(WS/T 677—2020)标准,本研究将血清浓度25(OH)D水平<12 ng/ml定义为维生素D缺乏组,≥20 ng/ml定义为维生素D正常组[7]。随机选择60例维生素D缺乏的儿童青少年作为病例组,按性别相同、年龄相近(两者相差≤1岁)的原则,筛选出维生素D正常的儿童青少年作为潜在对照组。通过随机数字表从潜在对照组中随机抽取1名儿童与病例组进行配对,最终匹配60例维生素D正常儿童青少年为对照组。所有选中的研究对象均接受非靶向代谢组学检测。本研究经广州市疾病预防控制中心伦理委员会审核批准(编号:GZCDC-ECHR-2022P0036),参与者及监护人在调查前均签署知情同意书。
采用问卷调查和体格检查收集儿童青少年的年龄、性别、户外活动时间、维生素D营养补充剂摄入、身高和体重信息,具体方法同本课题组前期文献[6]。根据测量的身高、体重计算体质指数(body mass index,BMI),BMI=体重(kg)/身高(m)2,并参照2007年WHO所定义的BMI年龄参考值[12]计算BMI z评分。
本研究参照相关文献,采用非靶向代谢组学方法,对血清样本进行分析[13-14]。样本制备时,血清样本从-80 ℃冰箱取出后在冰上解冻并涡旋混匀,取50 μl样本与300 μl的20%乙腈甲醇提取液混匀后离心(离心半径17.5 cm、1 200 r/min离心10 min),提取上清液并再次离心(离心半径17.5 cm、1 200 r/min离心10 min),最终转移180μl上清液用于分析。质量控制(quality control, QC)样品由所有血清样品等体积混合而成,每10个样本插入一个QC样品以确保分析稳健性。色谱条件为Waters ACQUITY UPLC HSS T3 C18色谱柱,流动相为含0.1%甲酸的水和乙腈,流速0.4 ml/min,进样量2 μl。质谱条件采用QTRAP © LC-MS/MS系统,正负离子模式扫描,ESI源温度500 ℃,电压5 500 V和-4 500 V,碰撞气体为氮气。代谢物定性与定量分析通过Analyst 1.6.3软件和自建数据库MWDB进行,最终使用MultiaQuant软件校正峰面积,得到代谢物相对含量。
采用R 4.4.1和SIMCA 14.1软件进行统计分析。涉及多重比较时,使用Benjamini-Hochberg方法调整P值以控制错误发现率(False discovery rate, FDR),得到校正P值(QFDR)。定量变量采用中位数和四分位间距MP25, P75)进行描述,组间比较采用非参数检验;定性变量采用率、构成比进行描述,组间比较采用χ2检验。
代谢数据经对数转换及标准化后,通过倍数变化法(Fold Change,FC)和正交偏最小二乘判别分析(Orthogonal projections to latent structures discriminant analysis,OPLS-DA)对样本数据进行单变量和多变量统计分析。以OPLS-DA中变量权重重要性排序(Variable importance in projection, VIP)>1、两组之间代谢物的FC值>1.25或<0.8的标准[15]筛选差异代谢物。再利用京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)数据库对这些差异代谢物进行代谢通路分析。
按7:3的比例将研究对象分为训练集和测试集[16],在训练集中以维生素D水平为因变量(维生素D正常组 = 0,维生素D缺乏组=1),采用logistic回归选取P<0.01且QFDR<0.1的差异代谢物[17]作为维生素D缺乏的潜在生物标志物,并通过受试者工作特征(Receiver operating characteristic, ROC)曲线比较训练集和测试集中这些差异代谢物的曲线下面积(Area under the curve, AUC)来评估准确性。
研究对象年龄为9.77~16.38岁,年龄中位数13.90(12.83,14.53)岁。维生素D正常组儿童青少年户外活动时间长于维生素D缺乏组(P=0.013),年龄、性别、维生素D营养剂补充行为、BMI z评分在两组间差异无统计学意义(P值均>0.05)。见表1
共检测出932种代谢物,涵盖氨基酸及其代谢物(187种)、脂肪酰类(153种)、有机酸及其衍生物(142种)、苯及其衍生物(92种)、甘油脂类和甘油磷脂类(84种)、杂环化合物(59种)、激素及激素相关物质(22种)、醇类和胺类(38种)等16大类。
OPLS-DA模型评分及模型置换检验结果显示,OPLS-DA模型的Q2值均大于0.5,表明该模型具有较高的可靠性和有效性;两组之间具有显著的分离界限,显示置换后的Q2值均高于原始值,说明模型没有过度拟合。见图1
采用倍数变化法和OPLS-DA筛选(同时满足FC值> 1.25或< 0.8和VIP值> 1)共得到56个差异代谢物,其中上调代谢物38个,下调代谢物18个。部分见表2
为进一步探索儿童青少年维生素D缺乏发生发展过程中的整体代谢改变,对筛选出的56种差异代谢物进行代谢通路分析,结果显示仅类固醇激素生物合成通路具有统计学意义(P= 0.001,QFDR=0.098 2),其他代谢通路如甘油磷脂代谢以及精氨酸和脯氨酸代谢通路无统计学意义(P值均>0.05,QFDR值均>0.1),但其影响值均大于0.01,提示它们可能对儿童青少年维生素 D缺乏具有潜在的影响。见图2
对类固醇激素生物合成通路富集的差异代谢物进行统计,发现其涵盖了表达上调的雄酮、二氢睾酮、雄甾烷醇酮、睾酮、雌酮3-硫酸盐共5种差异代谢物,见图3
将研究对象划分为训练集(84例)和测试集(36例)。在训练集中,对初步筛选的56种差异代谢物建模进行logistic回归分析,经调整户外活动时间后,结果显示7,8-环氧基-4Z,10Z,13Z,16Z,19Z-等12种代谢物与维生素D缺乏情况的关联具有统计学意义(P值均<0.01且QFDR均<0.1)。见表3
通过进一步ROC曲线分析,结果显示上述12种代谢物在训练集(AUC=0.922,95% CI: 0.865~0.978)和测试集(AUC=0.910,95% CI: 0.809~1)中均展现出较高的准确性(AUC值均> 0.7)。见图4
本研究将研究对象分为维生素D缺乏组和正常组,两组在年龄、性别、BMI z评分等基线特征上的差异无统计学意义。维生素D正常组的户外活动时间长于缺乏组,这与既往研究一致[18-19]。由于人体主要通过紫外线照射皮肤产生获得维生素D,户外活动时间越长,皮肤暴露于紫外线的时间也越长,有助于维生素D合成。
本研究筛选出56种维生素D缺乏相关的差异代谢物,含雄酮、二氢睾酮等激素类物质。维生素D缺乏的代谢通路分析显示,类固醇激素生物合成通路具有统计学意义,且该通路涵盖了表达上调的5种性激素,提示维生素D与性激素水平可能存在负相关,这与一些研究结果一致[20-22]。原因可能为:(1)季节性因素:本研究开展于3—5月,日照时长较夏季短,维生素D内源性合成减少[23],而总睾酮和游离睾酮等性激素水平则表现为夏季低冬季高[21];(2)营养与代谢因素:维生素D可升高血清钙和磷酸盐水平[24],而钙离子可对性激素的合成和分泌产生负性影响[25]。然而,部分研究显示维生素D与性激素呈正相关[26],二者关系尚未达成共识[27],需进一步探索。此外,本研究中甘油磷脂代谢通路及精氨酸和脯氨酸代谢通路虽无统计学意义,但影响值超过 0.01,提示它们可能具有潜在影响,这一发现与其他人群相关研究结果类似[9,11]
本研究采用logistic回归进一步筛选差异代谢物,该方法在相关研究中已被验证并应用[10,28]。机器学习方法通常适用于高通量数据分析,依赖大样本量数据,而本研究通过倍数变化法和OPLS-DA初步筛选出来的56种差异代谢物已显著降低数据维度,且样本量有限,因此采用机器学习法并不是最优选择[29]。Logistic回归能够在有限样本分析时避免机器学习模型的过拟合问题,且可与本研究前期初筛方法互补提高结果的稳定性和可靠性。
基于上述方法学考量,本研究采用logistic回归进一步筛选出12种潜在生物标志物,这些标志物与维生素D缺乏所诱导的炎症反应及下丘脑-垂体-性腺轴功能紊乱密切相关。本研究显示,脂肪酰类代谢物占主导地位,且大部分与炎症反应相关,这提示维生素D缺乏可能解除对环氧合酶-2(COX-2)的抑制(维生素D充足时该酶呈被抑制状态[30]),促进花生四烯酸转化为前列腺素,16,16-二甲基前列腺素A2和11-羟基-12E,14Z-二十碳二烯酸等物质水平上升,加剧炎症反应。此外,有研究表明,11-β-羟基雄酮的水平升高与类固醇激素生物合成通路的异常激活相关[31],这与本研究代谢通路分析一致;另有研究显示,维生素D缺乏与儿童中枢性性早熟发病风险呈正相关[32],这可能与维生素D缺乏人群胰岛素样生长因子-1(IGF-1)水平升高促进促性腺激素释放激素分泌有关[33],从而进一步解释维生素D缺乏可扰乱下丘脑-垂体-性腺轴的功能。
综上,本研究结合血清25(OH)D水平测定与非靶向代谢组学分析相结合,揭示了儿童青少年维生素D缺乏的代谢特征,并筛选出12种高准确性的潜在生物标志物,为维生素D缺乏的早期识别提供依据。
本研究存在一定的局限性。一是研究采用了病例对照设计,无法直接确定因果关系。二是样本仅包括维生素D水平缺乏和正常的群体,未涵盖不足者,限制了对不足状态下代谢特征的理解。三是研究对象来自广州市农村地区,影响结论的外推性。未来需扩大样本量,涵盖更多地区和人群,以深入理解儿童青少年维生素D缺乏的代谢特征并验证潜在生物标志物的潜力。
  • 广州市科技计划项目(2023A03J0940)
  • 广州市科技计划项目(2023A03J0451)
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doi: 10.20043/j.cnki.MPM.202501167
  • 接收时间:2025-01-10
  • 首发时间:2026-03-19
  • 出版时间:2025-06-25
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  • 收稿日期:2025-01-10
基金
广州市科技计划项目(2023A03J0940)
广州市科技计划项目(2023A03J0451)
作者信息
    1.中山大学公共卫生学院,广东 广州 510080
    2.广州市疾病预防控制中心(广州市卫生监督所)食品安全与营养部

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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