Quantitative method and multiple statistical methods were used to compare the effect of folic acid and its related metabolites on risk assessment and prediction of neural tube defects. First, a previously established HPLC-MS/MS method was employed to determine the levels of these metabolites in maternal serum samples of 121 cases and 118 controls. Then two-sample t test (p<0.05) was used to obtain differential metabolites between these two groups. At last, Logistic regression and receiver operating characteristic (ROC ) analysis were employed to calculate the odds ratio, sensitivity and specificity, positive and negative predictive rate of these metabolites. Results showed that among the 4 differential metabolites, 5-methyltetrahydrofolate and homocysteine both got higher odds ratio, positive and negative predictive rate than folic acid. The method was suitable for screening and assessment of disease biomarkers.%以叶酸及其相关代谢物为研究对象,结合定量分析方法以及多种统计学方法,比较它们在神经管畸形发病风险评估和预测中的作用.采用前期建立的HPLC-MS/MS方法测定了121例病例和118例对照母体血清中的代谢物水平,通过双样本成对t检验筛选差异代谢物(p＜0.05),然后利用Logistic回归和ROC分析计算这些代谢物的优势比以及预测灵敏度及特异性、阳性和阴性预测率.结果表明,4种差异代谢物中,5-甲基四氢叶酸和同型半胱氨酸的优势比、阳性和阴性预测率均高于叶酸.本方法适用于疾病标志物的筛选和评价.
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