The Abnormal Metabolites in Tongue Coating of Chronic Gastritis Patients Reflect the Changes in Indexes of Gastroscopic Observation and Gastric Mucosal Pathology
Authors: Xu Yifeng , Zhang Renling , Lu Junhong , Zhu Zhujing , Wang Yiqin , Hao Yiming 
Published: November 2021

Abstract
ObjectiveIn this study, we analyzed the correlation between different metabolites in the tongue coating of patients with chronic gastritis, gastroscopy and pathological indexes, and discussed the metabolic mechanism at different pathological stages in the development of chronic gastritis.MethodsWe used GC-TOF-MS and UHPLC-QE-MS metabonomics to detect the distribution of metabolites in the tongue coating of patients with chronic gastritis, and analyzed the correlation between different metabolites in the tongue coating of patients with chronic gastritis and gastroscopy and pathological indexes.ResultsCompared with 50 healthy people, 54 metabolites were upregulated and 47 metabolites were downregulated in 350 patients with chronic gastritis. The main differential metabolites were Lipids and lipid-like molecules, which contain 47 metabolites. The best diagnostic model was composed of 5 metabolites, with an accuracy of 95.4%, a specificity of 87.4% and a sensitivity of 88.0%. These 5 metabolites were 1-methyladenosine, Sphinganine 1-phosphate, 3-Hydroxycapric acid, 4-Ipomeanol, and Nervonic acid. Compared with healthy people, Sphinganine 1-phosphate, 4-Ipomeanol, and Nervonic acid were significantly upregulated in chronic gastritis patients, and 1-methyladenosine and 3-Hydroxycapric acid were significantly downregulated in chronic gastritis patients. After correlation analysis between differential metabolites in tongue coatings and gastroscopic indexes, we found that Trimethylaminoacetone, Sphinganine1-phosphate, alpha-Carboxy-delta-decalactone, and 5,6-Dihydroxyindole were positively correlated with intestinal metaplasia. Conduritol-beta-expoxide, Tetracosanoic acid, Lactosylceramide(d18:1/26:0), Chondrillasterol 3-[glucosyl-(1->4)-glucoside], Azelaic acid, and 1-Methyladenosine were negatively correlated with intestinal metaplasia. Sphinganine1-phosphate, alpha-Carboxy-delta-decalactone, and 5,6-Dihydroxyindole were positively correlated with atrophic. Octadecanol, conduritol-beta-expoxide, Tetracosanoic acid, Smilanippin A, Lactosylceramide(d18:1/26:0), Chondrillasterol 3-[glucosyl-(1->4)-glucoside], and Azelaic acid were negatively correlated with atrophic. 6-deoxyglucitol was negatively correlated with bile reflux, methylmaleic acid, 4-methylcatechol, and 2,4-dichloro-1-(2-chloroethenyl)-benzene were negatively correlated with Hp, 3-benzoyloxy-11-oxo-12-ursen-28-oic acid was negatively correlated with gastric mucosal erosion. From the change trend of different metabolites in different pathological stages, we found that the content of conduritol-beta-expoxide decreased significantly in mild atrophic compared with moderate atrophic and the content of conduritol-beta-expoxide decreased significantly in mild intestinal metaplasia compared with moderate intestinal metaplasia.ConclusionsWe found that Lipids and lipid-like molecules were the main abnormal metabolites in patients with chronic gastritis. Among them, Sphinganine 1-phosphate, which was significantly positively correlated with the aggravation of atrophic and intestinal metaplasia, could be used as one of the diagnostic model markers for chronic gastritis. Additionally, the amount of conduritol-beta-expoxide significantly decreased with the aggravation of atrophic and intestinal metaplasia. We believe that these differential markers in tongue coating may help us to establish a noninvasive and convenient auxiliary detection method for gastritis and gastric precancerous lesion in the future.