Analysis of metabolites in serum and villous tissue of missed abortion patients based on targeted metabolomics

This is the authors' abstract. We don't add key points for this paper.

Objective: In recent years, advancements in metabolomics have highlighted that changes in metabolic states within the body might also be closely related to missed abortion. However, the specific impacts of metabolic abnormalities on missed abortion remain unclear. This study screened differential metabolites in serum and villous tissues from patients with missed abortion, analyzed possible mechanisms linking metabolic disturbances to disease occurrence, and explored their clinical research value in early pregnancy abnormality research. Methods: Focusing on the effect of abnormal levels of metabolites on missed abortion, a prospective case-control study was conducted including 78 women with missed abortion and 75 women with normal early pregnancy undergoing elective termination. Targeted metabolomics profiling of serum and villous tissues was performed using mass spectrometry. Clinical characteristics and metabolite levels were compared between groups. Firth's logistic regression was applied to assess independent associations. ROC curve analysis was used to evaluate the discriminatory potential of key metabolites. Results: Results revealed metabolic differences in both serum and villous tissues between the missed abortion and control groups. Serum was characterized by upregulated amino acid metabolism, with elevated levels of multiple amino acids including ORN and TYR, which were associated with the risk of missed abortion. Villous tissues exhibited core disturbances in acylcarnitine metabolism, with C10:1 and C18 significantly upregulated in the missed abortion group. Notably, no highly consistent differential metabolites were identified between serum and villous tissues. Conclusion: This study demonstrates distinct metabolic signatures in missed abortion, with amino acid upregulation in serum and acylcarnitine disorder in villous tissues. Only CIT was consistently upregulated in both matrices, possibly due to limited assay coverage. Combined panels of the top eight FDR-ranked metabolites achieved high AUCs in serum and villous tissue, offering good auxiliary discrimination for missed abortion. These findings provide new insights into its metabolic pathogenesis.