Metabolomic fingerprints of clustered preterm and term neonates – a pilot study
IntroductionAdrenal steroidogenesis plays a pivotal role in neonatal adaptation, and advanced steroid profiling offers novel insights into disease risks and personalized management strategies. This study aimed to identify adrenal steroid metabolomic clusters in neonates and to correlate them with cl...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1569355/full |
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| author | Miłosz Lorek Miłosz Lorek Teresa Joanna Stradomska Anna Siejka Janusz Fuchs Dominika Januś Aneta Gawlik-Starzyk |
| author_facet | Miłosz Lorek Miłosz Lorek Teresa Joanna Stradomska Anna Siejka Janusz Fuchs Dominika Januś Aneta Gawlik-Starzyk |
| author_sort | Miłosz Lorek |
| collection | DOAJ |
| description | IntroductionAdrenal steroidogenesis plays a pivotal role in neonatal adaptation, and advanced steroid profiling offers novel insights into disease risks and personalized management strategies. This study aimed to identify adrenal steroid metabolomic clusters in neonates and to correlate them with clinical outcomes.MethodsIn a prospective observational design (June 2021–July 2022), 50 neonates (12 early preterm, 18 late preterm, and 20 full-term) admitted with respiratory distress underwent continuous 24-hour urine collection via an urinary catheter. Steroid profiles were analyzed by gas chromatography–mass spectrometry. K-means clustering was employed to classify the metabolomic data, which were subsequently correlated with mortality, bronchopulmonary dysplasia (BPD), small for gestational age (SGA), and intraventricular hemorrhage (IVH).ResultsK-means analysis delineated three distinct metabolic clusters. Cluster 1 displayed a profoundly suppressed steroidogenesis (low C19 and C21 excretion, diminished 3β-hydroxysteroid dehydrogenase and 5α-reductase activities), correlating with an increased incidence of BPD, high mortality risk scores, and significant rates of SGA/intrauterine growth restriction. Cluster 2 exhibited adrenal hyperactivation with elevated cortisol/cortisone derivatives, moderately increased C19/C21 metabolites, and partial 3β-HSD deficits, associated with a heightened risk of IVH and mortality. Cluster 3 showed robust steroidogenesis (high C19/C21 excretion and high 3β-HSD/5α-reductase activities), accompanied by the lowest mortality rates and absence of BPD or SGA/IUGR.ConclusionsSuppressed steroidogenesis increased BPD, SGA, and mortality, while excessive cortisol output in Cluster 2 was associated with a higher risk of IVH. Robust steroidogenesis supported favorable outcomes, highlighting the potential for metabolome-guided interventions. |
| format | Article |
| id | doaj-art-2c657388a1504ed69963f99341bcdd69 |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-2c657388a1504ed69963f99341bcdd692025-08-20T03:10:05ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15693551569355Metabolomic fingerprints of clustered preterm and term neonates – a pilot studyMiłosz Lorek0Miłosz Lorek1Teresa Joanna Stradomska2Anna Siejka3Janusz Fuchs4Dominika Januś5Aneta Gawlik-Starzyk6Department of Neonatal and Pediatric Intensive Care, John Paul II Center for Child and Family Health, Sosnowiec, PolandDepartment of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, Katowice, PolandLaboratory for the Diagnosis of Metabolic Disorders and Steroidogenesis, The Children's Memorial Health Institute, Warsaw, PolandLaboratory for the Diagnosis of Metabolic Disorders and Steroidogenesis, The Children's Memorial Health Institute, Warsaw, PolandDepartment of Neonatal and Pediatric Intensive Care, John Paul II Center for Child and Family Health, Sosnowiec, PolandDepartment of Paediatric and Adolescent Endocrinology, Jagiellonian University Medical College, University Children's Hospital, Krakow, PolandDepartment of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, Katowice, PolandIntroductionAdrenal steroidogenesis plays a pivotal role in neonatal adaptation, and advanced steroid profiling offers novel insights into disease risks and personalized management strategies. This study aimed to identify adrenal steroid metabolomic clusters in neonates and to correlate them with clinical outcomes.MethodsIn a prospective observational design (June 2021–July 2022), 50 neonates (12 early preterm, 18 late preterm, and 20 full-term) admitted with respiratory distress underwent continuous 24-hour urine collection via an urinary catheter. Steroid profiles were analyzed by gas chromatography–mass spectrometry. K-means clustering was employed to classify the metabolomic data, which were subsequently correlated with mortality, bronchopulmonary dysplasia (BPD), small for gestational age (SGA), and intraventricular hemorrhage (IVH).ResultsK-means analysis delineated three distinct metabolic clusters. Cluster 1 displayed a profoundly suppressed steroidogenesis (low C19 and C21 excretion, diminished 3β-hydroxysteroid dehydrogenase and 5α-reductase activities), correlating with an increased incidence of BPD, high mortality risk scores, and significant rates of SGA/intrauterine growth restriction. Cluster 2 exhibited adrenal hyperactivation with elevated cortisol/cortisone derivatives, moderately increased C19/C21 metabolites, and partial 3β-HSD deficits, associated with a heightened risk of IVH and mortality. Cluster 3 showed robust steroidogenesis (high C19/C21 excretion and high 3β-HSD/5α-reductase activities), accompanied by the lowest mortality rates and absence of BPD or SGA/IUGR.ConclusionsSuppressed steroidogenesis increased BPD, SGA, and mortality, while excessive cortisol output in Cluster 2 was associated with a higher risk of IVH. Robust steroidogenesis supported favorable outcomes, highlighting the potential for metabolome-guided interventions.https://www.frontiersin.org/articles/10.3389/fendo.2025.1569355/fullneonatesadrenalssteroidogenesismetabolomicsK-means clustering |
| spellingShingle | Miłosz Lorek Miłosz Lorek Teresa Joanna Stradomska Anna Siejka Janusz Fuchs Dominika Januś Aneta Gawlik-Starzyk Metabolomic fingerprints of clustered preterm and term neonates – a pilot study Frontiers in Endocrinology neonates adrenals steroidogenesis metabolomics K-means clustering |
| title | Metabolomic fingerprints of clustered preterm and term neonates – a pilot study |
| title_full | Metabolomic fingerprints of clustered preterm and term neonates – a pilot study |
| title_fullStr | Metabolomic fingerprints of clustered preterm and term neonates – a pilot study |
| title_full_unstemmed | Metabolomic fingerprints of clustered preterm and term neonates – a pilot study |
| title_short | Metabolomic fingerprints of clustered preterm and term neonates – a pilot study |
| title_sort | metabolomic fingerprints of clustered preterm and term neonates a pilot study |
| topic | neonates adrenals steroidogenesis metabolomics K-means clustering |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1569355/full |
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