Amino acids of blood and organic acids of urine in determining metabolic status with perinatal hypoxic-ischemic brain damage

Abstract

Introduction. Hypoxic-ischemic lesions (GUI) of the brain are a frequent cause of disability and disadaptation of children. The role and interaction of metabolic pathways in the mechanisms of their development are not yet clear.Objective: to study changes in the levels of amino acids (AA) of blood and organic acids (OA) of urine with perinatal hypoxic-ischemic brain damage.Materials and methods: 117 infants with GUI were examined (60 of them in the acute period - before the age of 1 month, and 57 in the early recovery period - at the age of 1 to 4 months), and 35 relatively healthy newborns. All children underwent a study of free AA blood by high-performance liquid chromatography. In 98 children with SMI, the urine was examined by gas chromatography-mass spectrometry.Results. Analysis of blood amino acids revealed: in the acute period of SMI, an increase in the levels of AA, which are mediators (glutamate, p = 0.001, glycine, p = 0.038), and methionine (p = 0.015) and AA, which are involved in energy metabolism and maintenance of a constant blood glucose levels: alanine (p = 0.001), threonine (p = 0.028), valine (p = 0.01), leucine (p = 0.021); decrease in levels of tryptophan (p = 0.0001) and tyrosine (p = 0.015), which are the precursors of neurotransmitters. In the early recovery period, changes in the AF of the urea cycle, a decrease in valine, were observed more frequently. In the analysis of urine, the most frequently altered metabolites of the Krebs cycle and the respiratory chain (more than 70% of cases), as well as branched chain metabolites (more than 60% of cases), which are also involved in energy metabolism. Correlations were found between changes in the levels of OA in urine and AF in the blood.Conclusions. Analysis of blood AA after perinatal hypoxia-ischemia revealed the most frequent changes in the levels of AA involved in energy, neurotransmitter metabolism, detoxification of ammonia. Changes in the urine of the urine and their correlation with changes in blood AA were revealed. The work demonstrates the feasibility of these studies for the pain of a deep assessment of the metabolic status after perinatal hypoxia.