Abstract
OBJECTIVE: Depression is a common comorbidity in hypertensive older adults, yet depression is more difficult to diagnose correctly. Our goal is to find predictive models of depression in hypertensive patients using a combination of various machine learning (ML) methods and metabolomics. METHODS: Methods We recruited 379 elderly people aged ≥65 years from the Chinese community. Plasma samples were collected and assayed by gas chromatography/liquid chromatography-mass spectrometry (GC/LC-MS). Orthogonal partial least squares discriminant analysis (OPLS-DA), volcano diagrams and thermograms were used to distinguish metabolites. The attribute discriminators CfsSubsetEval combined with search method BestFirst in WEKA software was used to find the best predicted metabolite combinations, and then 24 classification methods with 10-fold cross-validation were used for prediction. RESULTS: 34 individuals were considered hypertensive combined with depression according to our criteria, and 34 subjects with hypertension only were matched according to age and sex. 19 metabolites by GC-MS and 65 metabolites by LC-MS contributed significantly to the differentiation between the depressed and non-depressed cohorts, with a VIP value of more than 1 and a P value of less than 0.05. There were multiple metabolic pathway alterations. The metabolite combinations screened with WEKA for optimal diagnostic value included 12 metabolites. The machine learning methods with AUC values greater than 0.9 were bayesNet and random forests, and their other evaluation measures are also better. CONCLUSION: Altered metabolites and metabolic pathways are present in older adults with hypertension combined with depression. Methods using metabolomics and machine learning performed quite well in predicting depression in hypertensive older adults, contributing to further clinical research.