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儿童遗尿症及共患神经行为障碍的尿液代谢表型分析。

Urine metabolic phenotyping in children with nocturnal enuresis and comorbid neurobehavioral disorders.

机构信息

Division of Pediatric Nephrology, Department of Pediatrics, Lin-Kou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, 5, Fusing Street, Gueishan, Taoyuan, 333, Taiwan.

Division of Pediatric Urology, Department of Urology, Lin-Kou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Sci Rep. 2021 Aug 16;11(1):16592. doi: 10.1038/s41598-021-96104-1.

Abstract

Nocturnal enuresis (NE) is a common problem among 10% school-aged children. The etiologies underlying childhood NE is complex and not fully understood nowadays. Nevertheless, increasing evidence suggests a potential link between neurobehavioral disorders and enuresis in children. In this study, we aimed to explore novel metabolomic insights into the pathophysiology of NE and also, its association with pediatric psychiatric problems. Urine collected from 41 bedwetting children and 27 healthy control children was analyzed by using H-nuclear magnetic resonance spectroscopy from August 2017 to December 2018. At regular follow-up, there were 14 children with refractory NE having a diagnosis of attention deficient hyperactivity disorder (ADHD) or anxiety. Eventually, we identified eight significantly differential urinary metabolites and particularly increased urinary excretion of betaine, creatine and guanidinoacetate linked to glycine, serine and threonine metabolism were associated with a comorbidity of neurobehavioral disorders in refractory bedwetting children. Notably, based on physiological functions of betaine acting as a renal osmolyte and methyl group donor, we speculated its potential role in modulation of renal and/or central circadian clock systems, becoming a useful urinary metabolic marker in diagnosis of treatment-resistant NE in children affected by these two disorders.

摘要

遗尿症(NE)是 10%学龄儿童中常见的问题。目前,儿童遗尿症的病因复杂,尚未完全了解。然而,越来越多的证据表明神经行为障碍与儿童遗尿症之间存在潜在联系。在这项研究中,我们旨在探索神经行为障碍与儿科精神问题之间的关系。我们分析了 2017 年 8 月至 2018 年 12 月期间收集的 41 名遗尿症儿童和 27 名健康对照组儿童的尿液,采用 H-核磁共振波谱法进行分析。在定期随访中,有 14 名难治性遗尿症儿童被诊断为注意缺陷多动障碍(ADHD)或焦虑症。最终,我们确定了 8 种差异明显的尿液代谢物,特别是甘氨酸、丝氨酸和苏氨酸代谢相关的甜菜碱、肌酸和胍基乙酸的尿液排泄增加与难治性遗尿症儿童的神经行为障碍共病有关。值得注意的是,基于甜菜碱作为肾脏渗透调节剂和甲基供体的生理功能,我们推测其在调节肾脏和/或中枢生物钟系统中的潜在作用,使其成为诊断受这两种疾病影响的治疗抵抗性遗尿症的有用尿液代谢标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0547/8368245/c153d8ad336c/41598_2021_96104_Fig1_HTML.jpg

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