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Metabolomics reveals key biomarkers for ischemic stroke: a systematic review of emerging evidence

Ding L, Zhang M, Fan B, Deng F, Li Z, Han Y, Wu Y, Zeng J et al.

Frontiers in neurology, 2025

5 citations

Abstract

Objective: To systematically collate and evaluate metabolomics-based biomarkers of ischemic stroke (IS) to guide clinical diagnosis and treatment.

Methods: Comprehensive literature searches were conducted in PubMed, Embase, and Web of Science using "IS" and "metabolomics" as core keywords, covering publications up through February 2024. Any original metabolomic research related to IS was selected. Key information such as study demographics, study type, objectives, metabolomic analysis methods, and main findings were extracted and analyzed. Frequently mentioned metabolites were subjected to enrichment analysis using the MetaboAnalyst 6.0 platform.

Results: A total of 51 studies were included. Quality assessment revealed that 54.8% of the diagnostic studies and 69.2% of the prognostic studies were high-quality, with most controlling for confounding factors. Metabolite analysis revealed associations between decreased proline, isoleucine, valine, and alanine levels with IS. Increased tyrosine, glutamine, phenylalanine, sphingomyelin, glutamate, lactate and glucose, and decreased LysoPC (18:2), histidine, and methionine levels were linked to IS onset. Specific metabolite combinations, such as serine, isoleucine, betaine, PC (5:0/5:0), and LysoPE (18:2), showed high precision in predicting acute ischemic stroke (AIS) (training set AUC = 0.988, test set AUC = 0.971). Glycine-serine-threonine and valine-leucine-isoleucine pathways were significant in diagnosing IS and AIS, and in…

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