Lusczek Elizabeth R, Paulo Joao A, Saltzman John R, Kadiyala Vivek, Banks Peter A, Beilman Greg, Conwell Darwin L
Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
JOP. 2013 Mar 10;14(2):161-70. doi: 10.6092/1590-8577/1294.
The characterization of the urinary metabolome may yield biomarkers indicative of pancreatitis.
We establish a non-invasive technique to compare urinary metabolic profiles in patients with acute and chronic pancreatitis to healthy controls.
Urine was obtained from healthy controls (HC, n=5), inpatients with mild acute pancreatitis (AP, n=5), and outpatients with chronic pancreatitis (CP, n=5). Proton nuclear magnetic resonance spectra were obtained for each sample. Metabolites were identified and quantified in each spectrum; resulting concentrations were normalized to account for differences in dilution among samples. Kruskal-Wallis test, post-hoc Mann-Whitney U tests, and principal component analysis were performed to identify metabolites that discriminate healthy controls, acute pancreatitis, and chronic pancreatitis.
Sixty metabolites were identified and quantified; five were found to differ significantly (P<0.05) among the three groups. Of these, citrate and adenosine remained significant after validation by random permutation. Principal component analysis demonstrated that healthy control urine samples can be differentiated from patients with chronic pancreatitis or acute pancreatitis; chronic pancreatitis patients could not be distinguished from acute pancreatitis patients.
This metabolomic investigation demonstrates that this non-invasive technique offers insight into the metabolic states of pancreatitis. Although the identified metabolites cannot conclusively be defined as biomarkers of disease, future studies will validate our findings in larger patient cohorts.
尿液代谢组的特征分析可能产生指示胰腺炎的生物标志物。
我们建立一种非侵入性技术，以比较急性和慢性胰腺炎患者与健康对照者的尿液代谢谱。
从健康对照者（HC，n = 5）、轻度急性胰腺炎住院患者（AP，n = 5）和慢性胰腺炎门诊患者（CP，n = 5）获取尿液。对每个样本进行质子核磁共振光谱分析。在每个光谱中鉴定并定量代谢物；将所得浓度进行归一化处理，以考虑样本间稀释差异。进行Kruskal-Wallis检验、事后Mann-Whitney U检验和主成分分析，以鉴定区分健康对照者、急性胰腺炎和慢性胰腺炎的代谢物。
鉴定并定量了60种代谢物；发现其中5种在三组之间存在显著差异（P<0.05）。其中，柠檬酸和腺苷在随机置换验证后仍具有显著性。主成分分析表明，健康对照者的尿液样本可与慢性胰腺炎或急性胰腺炎患者的样本区分开来；慢性胰腺炎患者与急性胰腺炎患者无法区分。
这项代谢组学研究表明，这种非侵入性技术有助于深入了解胰腺炎的代谢状态。尽管所鉴定的代谢物不能最终确定为疾病的生物标志物，但未来的研究将在更大的患者队列中验证我们的发现。
