Identification of serum metabolic markers in non-obese hypertensive patients using non-targeted metabolomics

The future of hypertension management lies in distinguishing disease subtypes for precise control. The underlying drivers and pathology of non-obese hypertension (J-HTN) remain unclear. There is a lack of biomarkers for the early identification of J-HTN. The aim of this study was to identify circulating metabolomic profiles that facilitate the early detection of J-HTN patients, thereby providing valuable insights for more targeted and precision-based therapies. A non-targeted metabolomics approach was used to quantify serum metabolites in 120 patients with newly diagnosed hypertension, and to determine the metabolomic characteristics of J-HTN and two types of obese hypertension (fat-dominant and muscle-dominant). 4 metabolites unique to J-HTN were identified, with lysophosphatidylcholine 22:6 (LysoPC(22:6/0:0)) standing out as the marker showing the most pronounced difference. Using the serum metabolome alone, we were able to distinguish J-HTN from other hypertensive patients. In a secondary validation with an independent cohort of 60 medically treated J-HTN patients, 3 metabolites, including LysoPC(22:6/0:0), remained significantly altered. The serum metabolic profiles identified in this study enable the early detection of J-HTN, with LysoPC(22:6/0:0) emerging as a highly promising biomarker. This metabolite may also correlate with the clinical efficacy of J-HTN treatments.