烧伤的长期神经系统结局及血浆代谢物谱和脑结构改变的潜在中介作用：一项前瞻性队列研究
Long-term neurological outcomes of burn injury and the potential mediating role of plasma metabolite profiles and brain structural alterations: A prospective cohort study.
文献信息
| PMID | 42868698 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Rui Feng |
| 作者单位 | Department of Burn and Plastic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China. |
| 期刊 | Burns : journal of the International Society for Burn Injuries |
| SCI 分区 | Q2 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 烧伤是一种常见的创伤事件，可导致长期神经系统后遗症，但其潜在机制仍知之甚少。我们旨在探究烧伤与长期神经系统结局之间的关联，并检验血浆代谢物谱和脑结构改变的潜在中介作用。
方法： 我们利用英国生物银行（UK Biobank）的数据开展了一项前瞻性队列研究。评估的神经系统结局包括卒中、肢体无力、听力损失、认知下降、抑郁、焦虑和失眠。使用核磁共振波谱法对血浆代谢组学进行分析，并在部分参与者中通过MRI获取脑结构指标。中介分析评估了代谢物或脑结构变化是否解释了烧伤与神经系统结局之间的关联。基于我们既往的研究，我们进行了一项更新的综述以对本研究结果进行背景化阐释。
结果： 烧伤与卒中（风险比[HR]：1.67；95%置信区间[CI]：1.42-1.97）、肢体无力（HR：1.45；95% CI：1.16-1.81）、听力损失（HR：1.48；95% CI：1.20-1.83）、认知下降（HR：1.42；95% CI：1.11-1.80）、焦虑（HR：1.33；95% CI：1.10-1.59）和失眠（HR：3.60；95% CI：2.69-4.80）的风险显著升高相关。血浆代谢物谱分析显示，脂蛋白亚类、脂肪酸组成和氨基酸代谢物存在持续性改变，其中若干改变部分中介了与卒中和肢体无力的关联。烧伤还与广泛的白质微结构异常和皮质灰质体积减少相关；然而，脑结构变化并未中介这些神经系统风险。
结论： 烧伤与长期神经系统风险升高相关，并伴有持续性的代谢和神经生物学改变。代谢失调部分中介了神经血管结局，而脑结构变化可能反映了平行或继发的过程。
英文摘要
BACKGROUND: Burn injury is a common traumatic event that can lead to long-term neurological sequelae, yet the underlying mechanisms remain poorly understood. We aimed to investigate the associations between burn injury and long-term neurological outcomes, and to examine the potential mediating roles of plasma metabolite profiles and brain structural alterations.
METHODS: We conducted a prospective cohort study using data from UK Biobank. Neurological outcomes-including stroke, limb weakness, hearing loss, cognitive decline, depression, anxiety, and insomnia-were assessed. Plasma metabolomics were profiled using NMR spectroscopy, and brain structural metrics were derived from MRI in a subset of participants. Mediation analyses evaluated whether metabolite or brain structural changes explained the associations between burn injury and neurological outcomes. An updated review was performed to contextualize our findings based on our previous study.
RESULTS: Burn injury was associated with significantly increased risks of stroke (hazard ratio [HR]: 1.67; 95% confidence interval [CI]: 1.42-1.97), limb weakness (HR: 1.45; 95% CI: 1.16-1.81), hearing loss (HR: 1.48; 95% CI: 1.20-1.83), cognitive decline (HR: 1.42; 95% CI: 1.11-1.80), anxiety (HR: 1.33; 95% CI: 1.10-1.59), and insomnia (HR: 3.60; 95% CI: 2.69-4.80). Plasma metabolite profiling revealed persistent alterations in lipoprotein subclasses, fatty acid composition, and amino acid metabolites, several of which partially mediated associations with stroke and limb weakness. Burn injury was also linked to widespread white matter microstructural abnormalities and reduced cortical gray matter volume; however, brain structural changes did not mediate the neurological risks.
CONCLUSIONS: Burn injury is associated with elevated long-term neurological risks, accompanied by persistent metabolic and neurobiological alterations. Metabolic dysregulation partially mediates neurovascular outcomes, while structural brain changes may reflect parallel or secondary processes.