Serum metabolomic analysis of lumbar disc herniation at different location based on UPLC-QTOF-MS/MS: a population study.

BACKGROUND: Almost all elderly individuals will encounter varying degrees of trouble caused by intervertebral disc degeneration. As a common degenerative spinal disorder, the harm of lumbar disc herniation (LDH) depends on the location of the nucleus pulposus herniation. However, population studies on the mechanisms of disc herniation at different levels are limited. Therefore, we conducted comparative analyses of serum metabolic characteristics in LDH patients with disc herniation at different locations. METHODS: In this study, 110 LDH patients (59 patients with L4-L5 protrusion site and 51 patients with L4-L5 protrusion site) were collected from June 2nd to October 1st, 2023 in Wuhan City, China. Untargeted metabolomics analysis based on ultra-high-pressure liquid chromatography coupled with quadrupole time of flight mass spectrometry (UPLC-QTOF-MS/MS) was analyzed the serum metabolic characteristics. RESULTS: As a result of principal component analysis (PCA) analysis, there was a clear separation trend in the metabolic profiles between L4-L5 and L5-S1 LDH patients in males, but not in females. Further, 28 metabolites with significant changes were screened in males with L4-L5 disc herniation compared to males with L5-S1 disc herniation. Among them, 25 metabolites were involved in glycerophospholipid metabolism, sphingolipid metabolism and tryptophan metabolism. CONCLUSION: These findings demonstrate gender-specific differences in LDH patients. Moreover, the location-specific metabolic signatures in males were uncovered. This study could provide new insights into the gender-specific degenerative mechanisms associated with lesions in different locations, and inform targeted rehabilitation strategies for managing LDH.