Metabolomic Plasma Profile of Chronic Obstructive Pulmonary Disease Patients.

The analysis of blood metabolites may help identify individuals at risk of having COPD and offer insights into its underlying pathophysiology. This study aimed to identify COPD-related metabolic alterations and generate a biological signature potentially useful for screening purposes. Plasma metabolomic profiles from 91 COPD patients and 91 controls were obtained using complementary semi-targeted and untargeted LC-MS approaches. Univariate analysis identified metabolites with significant differences between groups, and enrichment analysis highlighted the most affected metabolic pathways. Multivariate analysis, including ROC curve assessment and machine learning algorithms, was applied to assess the discriminatory capacity of selected metabolites. After adjustment for major potential confounders, 56 metabolites showed significant differences between COPD patients and controls. The enrichment analysis revealed that COPD-associated metabolic alterations primarily involved lipid metabolism (especially fatty acids and acylcarnitines), followed by amino acid pathways and xenobiotics. A panel of 10 metabolites, mostly related to lipid metabolism, demonstrated high discriminatory performance for COPD (ROC-AUC: 0.916; 90.1% sensitivity and 89% specificity). These findings may contribute to improving screening strategies and a better understanding of COPD-related metabolic changes. However, our findings remain exploratory and should be interpreted with caution, needing further validation and mechanistic studies.