Diagnosing diabetic nephropathy by 1H NMR metabonomics of serum
Diagnosing diabetic nephropathy by 1H NMR metabonomics of serum
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DOI：
10.1007/s10334-006-0054-y
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发表时间：
2006-12-01
影响因子：
2.3
通讯作者：
Ala-Korpela, Mika
中科院分区：
文献类型：
--
作者：
Makinen, Vine-Petteri;Soininen, Pasi;Ala-Korpela, Mika
目的：1型糖尿病（T1 DM）最严重的并发症是糖尿病肾病。它与心血管并发症和过早死亡的高风险相关，需要早期发现才能有效治疗。诊断糖尿病肾病的临床实践也是基于多个过夜或24小时尿液样本中的白蛋白排泄率的非最佳且繁琐的设置。相反，在这项研究中，这些独立的诊断数据被用来提供一个现实的测试情况下，应用H-1 NMR代谢组学的血清中的诊断方式。材料与方法：对182例T1 DM和21例非T1 DM患者进行研究。结果：T1 DM和非T1 DM患者血清中的脂蛋白和低分子量代谢物在500 MHz的H-1 NMR谱上被完全分离。对于T1 DM患者的糖尿病肾病诊断，H-1 NMR数据（和临床生化数据）的灵敏度为87.1%（83.9%），特异性为87.7%（95.9%）。阳性和阴性试验的预测值分别为89.0%（95.5%）和83.6%（79.2%），forecasts.Conclusions：H-1 NMR代谢组学清楚地区分代谢特征的T1 DM和出现近似作为一个很好的手段，从血清中诊断糖尿病肾病的一组先进的生化变量。
Object: The most severe complication of type 1 diabetes (T1DM) is diabetic nephropathy. It is associated with a high risk of cardiovascular complications and premature death and requires early detection to be efficiently treated. The clinical practice to diagnose diabetic nephropathy is also a non-optimal and tedious set up based on albumin excretion rate in multiple overnight or 24h urine samples. Conversely, in this study, these independent diagnostic data are used to provide a realistic testing case for applying H-1 NMR metabonomics of serum in a diagnostic fashion. \Materials and Methods: 182 T1DM and 21 non-diabetic (non-T1DM) individuals were studied. The H-1 NMR of serum at 500 MHz was targeted at two molecular windows: lipoprotein lipids and low-molecular-weight metabolites.Results: T1DM and non-T1DM individuals were exclusively separated by H-1 NMR. For diabetic nephropathy diagnosis in the T1DM patients, H-1 NMR data (and clinical biochemistry data) gave a sensitivity of 87.1% (83.9%) and a specificity of 87.7% (95.9%). The predictive values of positive and negative tests were 89.0% (95.5%) and 83.6% (79.2%), respectively.Conclusions: H-1 NMR metabonomics clearly distinguishes metabolic characteristics of T1DM and appears approximately as good a means to diagnose diabetic nephropathy from serum as an advanced set of biochemical variables.