Background Severe burn injury causes a hypermetabolic response, resulting in muscle protein catabolism and multiple organ damage syndrome. However, this response has not yet been continuously characterized by metabolomics in patients. This study aims to quantify temporal changes in the metabolic processes of patients with severe burns. Methods We employed 1H-nuclear magnetic resonance (NMR) spectroscopy to scrutinize metabolic alterations during the initial 35 days following burn injury in a cohort of 17 adult patients with severe burns, with 10 healthy individuals included as controls. Plasma specimens were collected from patients on postburn days 1, 3, 7, 14, 21, 28 and 35. After performing multivariate statistical analysis, repeated-measures analysis of variance and time-series analysis, we quantified changes in metabolite concentrations. Results Among the 36 metabolites quantified across 119 samples from burn patients, branched-chain amino acids, glutamate, glycine, glucose, pyruvate, lactate, trimethylamine N-oxide and others exhibited obvious temporal variations in concentration. Notably, these metabolites could be categorized into three clusters based on their temporal characteristics. The initial response to injury was characterized by changes in lactate and amino acids, while later changes were driven by an increase in fatty acid catabolism and microbial metabolism, leading to the accumulation of ketone bodies and microbial metabolites. Conclusions Metabolomics techniques utilizing NMR have the potential to monitor the intricate processes of metabolism in patients with severe burns. This study confirmed that the third day after burn injury serves as the boundary between the ebb phase and the flow phase. Furthermore, identification of three distinct temporal patterns of metabolites revealed the intrinsic temporal relationships between these metabolites, providing clinical data for optimizing therapeutic strategies.

中文翻译：

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1H-核磁共振分析揭示严重烧伤患者代谢特征的动态变化


背景 严重烧伤会引起代谢亢进反应，导致肌肉蛋白质分解代谢和多器官损伤综合征。然而，这种反应尚未通过患者代谢组学持续表征。本研究旨在量化严重烧伤患者代谢过程的时间变化。方法 我们采用 1H 核磁共振 (NMR) 波谱来检查 17 名严重烧伤成年患者在烧伤后最初 35 天内的代谢变化，其中 10 名健康个体作为对照。在烧伤后第1、3、7、14、21、28和35天从患者身上采集血浆标本。在进行多变量统计分析、重复测量方差分析和时间序列分析后，我们量化了代谢物浓度的变化。结果 在烧伤患者的 119 个样本中定量的 36 种代谢物中，支链氨基酸、谷氨酸、甘氨酸、葡萄糖、丙酮酸、乳酸、三甲胺 N-氧化物等表现出明显的浓度随时间变化。值得注意的是，这些代谢物可以根据其时间特征分为三类。对损伤的最初反应以乳酸和氨基酸的变化为特征，而后来的变化是由脂肪酸分解代谢和微生物代谢的增加驱动的，导致酮体和微生物代谢物的积累。结论 利用核磁共振的代谢组学技术有可能监测严重烧伤患者复杂的代谢过程。这项研究证实，烧伤后第三天是潮起潮落的分界线。 此外，对三种不同的代谢物时间模式的识别揭示了这些代谢物之间的内在时间关系，为优化治疗策略提供了临床数据。