Sparse Machine Learning Pipeline with Stabl Identifies Cord Blood Multi-Omic Signatures of Bronchopulmonary Dysplasia

Background: Several omics studies have been completed in recent years, with the goal of identifying biomarkers of complex multifactorial diseases, such as bronchopulmonary dysplasia (BPD). Objective: To evaluate the performance of 3 distinct omics platforms, using a machine learning pipeline with integration of sparse, reliable and adaptive biomarker identification (Stabl). Methods: Using a well-characterized birth cohort, cord blood metabolomics, proteomics and adductomics data were integrated with Least Absolute Shrinkage and Selection Operator (LASSO) regression and Stabl, to evaluate predictive performance for BPD. Results: Sparse multivariable modeling of 45,000 features measured in 217 infants (52 term, 165 extremely preterm <28 weeks; 82 with BPD and 35 with severe BPD/death) identified a perfect signature for preterm birth with both LASSO and Stabl (AUROC=1.0; p<0.001). Analysis of the preterm group yielded excellent predictive power for severe BPD (AUROC=0.83; p=0.005). Stabl identified a set of 12 biomarkers (2 adducts, 3 proteins and 7 metabolites) with good performance for predicting grade III BPD (AUROC=0.76; P=0.03). Biomarkers across the 3 omics platforms revealed dysregulated pathways of innate/adaptive immune responses, metabolic programming and oxidative stress. Conclusions: The sparse machine learning pipeline is a complementary approach for identifying novel pathways and biomarkers of multifactorial BPD and its endotypes.