Precis Future Med.  2023 Mar;7(1):33-43. 10.23838/pfm.2022.00128.

Signatory metabolomics biomarkers of stress, anxiety, and depression: a proof of concept for precision health among university students: A cross-sectional study

Affiliations
  • 1Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Selangor, Puncak Alam Campus, Puncak Alam, Malaysia
  • 2Faculty of Pharmacy, Universiti Teknologi MARA Selangor, Puncak Alam Campus, Puncak Alam, Malaysia
  • 3Faculty of Dentistry, Universiti Teknologi MARA Selangor, Sungai Buloh Campus, Sungai Buloh, Malaysia
  • 4Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Puncak Alam Campus, Puncak Alam, Malaysia
  • 5Faculty Education, Universiti Teknologi MARA Selangor, Puncak Alam Campus, Puncak Alam, Malaysia
  • 6Faculty of Computer & Mathematics, Universiti Teknologi MARA, Shah Alam, Malaysia
  • 7Faculty of Civil Engineering, Universiti Teknologi MARA, Shah Alam, Malaysia
  • 8UNITAR International University, Petaling Jaya, Malaysia

Abstract

Purpose
The highly competitive nature of tertiary education and the pressure to perform academically have increased psychological morbidity like emotional distress. Untargeted metabolomics was used to analyze serum samples of university students for biomarkers and perturbated metabolism due to stress, anxiety, and depression (SAD).
Methods
Depression, Anxiety, Stress Scale 21 (DASS-21) was used to assess the severity of SAD in university students. The metabolite fingerprint of each subject was obtained using liquid chromatography-mass spectrometry quadrupole time-of-flight (LC/MS QTOF). The signature metabolites for each trait were determined by projections to latent structures discriminant analysis (PLS-DA) with variable importance for the projection (VIP) score > 1.0 (P<0.05) and subjected to analysis using the area under the receiver operating characteristic curve (AUROC). Potential biomarkers with an area under the curve (AUC) value exceeding 0.65 were identified.
Results
Various groups of glycerophospholipids were upregulated in the studied traits. On the other hand, metabolites such as glycocholic acid was upregulated in depression, while hypoxanthine was upregulated in anxiety, and PE-Cer(d14:1(4E)/22:1(13Z)) was upregulated in stress.
Conclusion
To our knowledge, this is the first study to assess the relationship of the differentially expressed metabolites in university students of different categories of SAD using the DASS-21 screening tool in Malaysia as we move forward with precision health.

Keyword

Anxiety; Biomarkers; Depression; Metabolomics; Students
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