Carnitine Intake and Serum Levels Associate Positively with Postnatal Growth and Brain Size at Term in Very Preterm Infants

Metabolomics Analysis Reveals Potential Biomarkers for Diffuse Axonal Injury Article Category: Original Work

BACKGROUND

Metabolism is essential for life maintenance, neurological function, and injury repair, yet its role in diffuse axonal injury (DAI) is not fully understood.

METHODS

Thirty patients with DAI and 34 patients without DAI were recruited based on the classification criteria using magnetic resonance imaging within 30 days of admission in this exploratory research. Serum samples and clinical parameters were collected on admission, with the Glasgow Outcome Scale Extended at 6 months after injury used as the neurological functional outcome. We did an untargeted metabolomic analysis using liquid chromatography-mass spectrometry.

RESULTS

The DAI group and non-DAI group showed significant differences in the expression levels of 27 metabolites in serum, as well as in pupillary light reflex, Glasgow Coma Scale score, and Marshall computed tomography score. Random forest analysis indicated that lysophosphatidylcholine 22:3 sn-2 and carnitine C8:1 greatly contributed to distinguishing patients with DAI from patients without DAI (MeanDecreaseGini: 3.81, 5.16). The combined prediction of DAI using these two metabolites yielded an area under the curve of 0.944, which was higher than the combination of clinical parameters.

CONCLUSIONS

The serum metabolomics revealed potential biomarkers for DAI and has significant value for exploring pathogenesis, determining early diagnosis, and improving long-term neurological function.

[Expert consensus on parenteral nutrition management in neonates (2025)]

Parenteral nutrition (PN) is widely utilized in the field of neonatology and is a critical life-saving intervention for critically ill neonates or preterm infants who cannot meet their energy and nutrient needs through enteral feeding. To further standardize and optimize the clinical management of PN, this consensus was developed by a working group based on relevant research progress both domestically and internationally. Employing the Grading of Recommendations Assessment, Development and Evaluation, the consensus presents 24 recommendations covering seven aspects of PN: indications, administration routes, energy, fluid volume, composition of nutritional solutions, timing of cessation, and monitoring. The aim is to provide guidance for relevant practitioners in PN management to improve the short-term and long-term outcomes for neonates.

Comprehensive review of the expanding roles of the carnitine pool in metabolic physiology: beyond fatty acid oxidation

Traditionally, the carnitine pool is closely related to fatty acid metabolism. However, with increasing research, the pleiotropic effects of the carnitine pool have gradually emerged. The purpose of this review is to comprehensively investigate of the emerging understanding of the pleiotropic role of the carnitine pool, carnitine/acylcarnitines are not only auxiliaries or metabolites of fatty acid oxidation, but also play more complex and diverse roles, including energy metabolism, mitochondrial homeostasis, epigenetic regulation, regulation of inflammation and the immune system, tumor biology, signal transduction, and neuroprotection. This review provides an overview of the complex network of carnitine synthesis, transport, shuttle, and regulation, carnitine/acylcarnitines have the potential to be used as communication molecules, biomarkers and therapeutic targets for multiple diseases, with profound effects on intercellular communication, metabolic interactions between organs and overall metabolic health. The purpose of this review is to comprehensively summarize the multidimensional biological effects of the carnitine pool beyond its traditional role in fatty acid oxidation and to summarize the systemic effects mediated by carnitine/acylcarnitine to provide new perspectives for pharmacological research and treatment innovation and new strategies for the prevention and treatment of a variety of diseases.

Precise and panoramic study on the nutritional components of specific milk of goats and sheep

This study analyzed human, goat, sheep, and pig milks using metabolomics, lipidomics, and proteomics, specifically untargeted LC-MS/MS metabolomics, untargeted LC-MS/MS lipidomics, and 4D-label-free proteomics. The aim was to determine differences among these milks and identify components with similar functions to human milk, providing a reference for the research and development of infant formulae. In goat milk, expression of lactoperoxidase, inosine, and allantoin were relatively high, while in sheep milk, concentrations of ceruloplasmin and alpha-ketoglutarate were higher. The content of linoleic acid (LA) was relatively high in both goat and sheep milks. A relatively high content of milk fat globule EGF factor 8 protein was found in pig milk.

L-carnitine: food sources, adequate and clinically effective doses

L-carnitine plays a key role in cell bioenergetics, it belongs to vitamin-like substances, but unlike vitamins, it not only comes from food, but is also synthesized in the body. Endogenous synthesis decreases with age, under certain physiological conditions, taking medications. In this regard, specialized food products (SFP) and food supplements are being developed, containing L-carnitine as one of the functional ingredients. Comparison of doses of L-carnitine approved for use in biologically active food supplements and specialized food products with doses that provide a clinical effect.A review of existing literature on this issue in recent years was carried out using the RSCI, Pubmed databases and in the Google Scholar, ResearchGate systems. The amount of L-carnitine contained in a daily portion of SPP is established by domestic regulatory documents based on an adequate level of daily intake for adults, which is 300 mg and the upper permissible level of daily intake in the composition of SFP and food supplements is 900 mg/day. Reception of L-carnitine 1–2 g per day. within 5–12 weeks led to an increase in its concentration in the blood plasma, and also improved the indicators of the antioxidant status. Long-term intake of L-carnitine in doses of 2–3 g in patients with dyslipidemia, type 2 diabetes (DM2) and cardiovascular diseased (CVD) led to an improvement in the lipid profile of blood plasma, glycemic control, and had an anti-inflammatory effect. The condition for achieving a clinical effect in patients is long-term use and high doses. The intake of physiological doses of L-carnitine is appropriate for individuals from risk groups. Clinically effective doses of L-carnitine, when used for at least 12 weeks, correspond to or are 2 times higher than the upper permissible intake level in the composition of SPP and dietary supplements.

Comparative lipidome study of maternal plasma, milk, and lamb plasma in sheep

Lipids play a critical role in neonate development and breastmilk is the newborn's major source of lipids. Milk lipids directly influence the neonate plasma lipid profile. The milk lipidome is dynamic, influenced by maternal factors and related to the maternal plasma lipidome. The close inter-relationship between the maternal plasma, milk and neonate plasma lipidomes is critical to understanding maternal-child health and nutrition. In this exploratory study, lipidomes of blood and breast milk from Suffolk sheep and matched lamb blood (n = 13), were profiled on day 34 post birth by untargeted mass spectrometry. Comparative multivariate analysis of the three matrices identified distinct differences in lipids and class of lipids amongst them. Paired analysis identified 346 differential lipids (DL) and 31 correlated lipids (CL) in maternal plasma and milk, 340 DL and 32 CL in lamb plasma and milk and 295 DL and 16 CL in maternal plasma and lamb plasma. Conversion of phosphatidic acid to phosphatidyl inositol was the most active pathway in lamb plasma compared to maternal plasma. This exploratory study illustrates the partitioning of lipids across maternal plasma, milk and lamb plasma and the dynamic relationship between them, reiterating the need to study these three matrices as one biological system.