Centre for Environmental Policy, Imperial College London, London SW7 2AZ, UK.
Toxins (Basel). 2011 Jul;3(7):815-33. doi: 10.3390/toxins3070815. Epub 2011 Jul 4.
(1)H NMR spectroscopy of urine has been applied to exploring metabolomic differences between people diagnosed with Balkan endemic nephropathy (BEN), and treated by haemodialysis, and those without overt renal disease in Romania and Bulgaria. Convenience sampling was made from patients receiving haemodialysis in hospital and healthy controls in their village. Principal component analysis clustered healthy controls from both countries together. Bulgarian BEN patients clustered separately from controls, though in the same space. However, Romanian BEN patients not only also clustered away from controls but also clustered separately from the BEN patients in Bulgaria. Notably, the urinary metabolomic data of two people sampled as Romanian controls clustered within the Romanian BEN group. One of these had been suspected of incipient symptoms of BEN at the time of selection as a 'healthy' control. This implies, at first sight, that metabolomic analysis can be predictive of impending morbidity before conventional criteria can diagnose BEN. Separate clustering of BEN patients from Romania and Bulgaria could indicate difference in aetiology of this particular silent renal atrophy in different geographic foci across the Balkans.
（1）对尿液的 1H NMR 光谱分析已被应用于探索罗马尼亚和保加利亚诊断为巴尔干地方性肾病（BEN）并接受血液透析治疗的人群与无明显肾脏疾病人群之间的代谢组学差异。采用方便抽样法从医院接受血液透析的患者和他们所在村庄的健康对照中进行抽样。主成分分析将来自两个国家的健康对照者聚集成一组。保加利亚 BEN 患者与对照组分离，但在同一区域。然而，罗马尼亚 BEN 患者不仅远离对照组，而且与保加利亚的 BEN 患者分离。值得注意的是，两名被抽样为罗马尼亚对照者的尿液代谢组学数据聚类在罗马尼亚 BEN 组内。其中一人在被选为“健康”对照者时已被怀疑有 BEN 的初期症状。这意味着，乍一看，代谢组学分析可以预测在常规标准能够诊断 BEN 之前即将发生的发病率。罗马尼亚和保加利亚 BEN 患者的单独聚类可能表明在巴尔干半岛不同地理焦点中这种特定的隐匿性肾萎缩的病因不同。
