Coal workers' pneumoconiosis (CWP) is one of the most common inhalation occupational diseases. It is no effective treatment methods. Early diagnosis of CWP could reduce mortality. Lipid mediators (LMs) as key mediators in the generation and resolution of inflammation, are natural biomarkers for diagnosis inflammatory disease, such as CWP. The UHPLC-MRM technique was used to detect LMs in urine. The metabolic network of LMs in CWP and CT group samples was comprehensively analyzed. Screening for major difference compounds between the two groups. Aimed to contribute to the early diagnosis and treatment of CWP. Urinary levels of 13-OxoODE, 9-OxoODE, and 9,10-EpOME were significantly higher in the CWP group compared with the CT group (P < 0.05). In the model group, the area under the receiver operating characteristic (ROC) for 9-OxoODE,13-OxoODE,9,10-EpOME was 84.4%, 73.3%, and 80.9%, respectively. In the validation group, the area under the ROC was 87.0%, 88.8%, and 68.8% for 9-OxoODE,13-OxoODE,9,10-EpOME, respectively. According to the logistic regression model, the area under the ROC was 80.4% in the model group and 86.7% in the validation group. 13-OxoODE,9-OxoODE,9,10-EpOME could be used as biomarkers for early diagnosis. Significant abnormalities of LOX and CYP450 enzyme pathways were seen in CWP organisms. Changes in the CYP450 enzyme pathway may be associated with PAHs.

煤工尘肺（CWP）是最常见的吸入性职业病之一。目前尚无有效的治疗方法。 CWP 的早期诊断可以降低死亡率。脂质介质 (LM) 作为炎症产生和消退的关键介质，是诊断炎症性疾病（例如 CWP）的天然生物标志物。 UHPLC-MRM技术用于检测尿液中的LM。对CWP和CT组样本中LM的代谢网络进行了全面分析。筛选两组之间的主要差异化合物。旨在为CWP的早期诊断和治疗做出贡献。 CWP组尿液中13-OxoODE、9-OxoODE和9,10-EpOME水平显着高于CT组（P < 0.05）。在模型组中，9-OxoODE、13-OxoODE、9,10-EpOME 的受试者工作特征（ROC）下面积分别为 84.4%、73.3% 和 80.9%。在验证组中，9-OxoODE、13-OxoODE、9,10-EpOME 的 ROC 下面积分别为 87.0%、88.8% 和 68.8%。根据逻辑回归模型，模型组的ROC下面积为80.4%，验证组的ROC下面积为86.7%。 13-OxoODE,9-OxoODE,9,10-EpOME可作为早期诊断的生物标志物。在 CWP 生物体中观察到LOX 和 CYP450 酶途径的显着异常。 CYP450 酶途径的变化可能与 PAH 相关。