Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (9): 36-42.doi: 10.6040/j.issn.1671-7554.0.2026.0666

• Clinical Medicine • Previous Articles    

Key molecular features of acute mountain sickness revealed by metabolomics

DING Wenjing1, YANG Yifan1, HU Xinyu1, CHEN Xiaolan1, XUE Xinying2, PAN Lei1   

  1. 1. Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;
    2. Department of Respiratory and Critical Care, Xuanwu Hospital Capital Medical University, Beijing 100053, China
  • Published:2026-09-09

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Abstract: Objective To compare physiological parameters and urinary metabolomic profiles between individuals with acute mountain sickness(AMS)and those without AMS after high-altitude exposure, and to screen AMS-related candidate urinary metabolites and metabolic pathways. Methods In 2024, seventy male participants recruited in Xizang after high-altitude exposure, aged 18-45(20.93±1.55)years, were included, comprising 41 without AMS and 29 with AMS(AMS group). Demographic characteristics and post-exposure physiological parameters, including peripheral oxygen saturation(SpO2), heart rate, blood pressure, mean arterial pressure, and rate pressure product, were compared between groups. Untargeted urinary metabolomics was performed to characterize metabolic differences. Orthogonal partial least squares discriminant analysis(OPLS-DA), differential metabolite screening, Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment, and ensemble feature selection(EFS)were further conducted. Results Compared with the non-AMS group, the AMS group had lower SpO2 and higher systolic blood pressure and rate pressure product(all P<0.05). A total of 5,587 urinary metabolites were detected. OPLS-DA showed a tendency toward separation between the two groups. Using variable importance in projection(VIP)>1 combined with P<0.05, 544 differential metabolites were identified, including 267 upregulated and 277 downregulated metabolites. KEGG analysis showed that these metabolites were mainly enriched in glycine, serine and threonine metabolism, tryptophan metabolism, the pentose phosphate pathway, arginine and proline metabolism, carbon metabolism and branched-chain amino acid-related pathways. EFS highlighted S-(2-carboxypropyl)glutathione, ribose, N-acetyltryptophan, 2-hydroxyglutaric acid, glutamate and 4-hydroxyproline as candidate metabolites with high discriminatory contributions. Conclusion Individuals with AMS exhibit more pronounced oxygen desaturation and increased cardiovascular load after high-altitude exposure, accompanied by altered urinary metabolic profiles. The differential metabolites were mainly involved in amino acid metabolism, carbohydrate metabolism, redox balance regulation, and lipid-related metabolism, suggesting that urinary metabolomics may provide useful clues for AMS-related mechanistic studies and candidate biomarker screening.

Key words: Acute mountain sickness, Urinary metabolomics, Hypoxia, Differential metabolites, Ensemble feature selection

CLC Number: 

  • R594.3
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