Metabolomics in Endocrinology: The Way Forward.

Metabolomics is a type of laboratory science used to understand the cellular and metabolic defects in any disease process. It comprehensively identifies endogenous and exogenous low-molecular-weight (<1 kDa) molecules or metabolites in a high-throughput manner. Mass spectrometry-based methods are used for metabolomics which can be targeted and non-targeted. Metabolomics workflow consists of sample acquisition, its preparation and extraction, separation, ionisation, data analysis, and metabolite detection and identification. Some of the commonly elevated metabolomes are branched-chain amino acids like isoleucine, leucine, and valine in diabetes, carnitine and glutamate in osteoporosis, deoxycholic acid and betahydroxybutyrate in pituitary tumours, glutamic acid, valine, isoleucine for malignant thyroid nodules, L-asparagine, L-glutamine, dimethylarginine for hyperparathyroidism, tetrahydro-11-doxycortisol for adrenal tumours, and oxidised glutathione for hypogonadism. Knowing metabolomics can help us formulate personalised treatment choices for precision medicine in endocrinology. The main challenge ahead of metabolomics is its technical complexity and cost-benefit issues.