Format

Send to

Choose Destination
Proteomics Clin Appl. 2019 Jul;13(4):e1800049. doi: 10.1002/prca.201800049. Epub 2019 Jan 4.

Urinary Metabolic Signature of Primary Aldosteronism: Gender and Subtype-Specific Alterations.

Author information

1
Department of Ecological and Biological Sciences, Tuscia University, 01100, Viterbo, Italy.
2
Departments of Biochemistry and Molecular Genetics, University of Colorado Denver, Anschutz Medical Campus, 80045, Aurora, CO, USA.
3
Department of Medicine, Unit of Internal Medicine, University of Verona, 37134, Verona, Italy.
4
Department of Medicine and Experimental Oncology, Division of Internal Medicine and Hypertension Unit, University of Turin, 10124, Turin, Italy.

Abstract

PURPOSE:

The current clinical investigation for primary aldosteronism (PA) diagnosis requires complex expensive tests from the initial suspicion to the final subtype classification, including invasive approaches; therefore, appropriate markers for subtype definition are greatly desirable. The present study performs a metabolomics analysis to further examine specific molecular signatures of PA urines EXPERIMENTAL DESIGN: The study considered PA subtype and gender-related differences using two orthogonal advanced UHPLC-MS metabolomics approaches. Patients with essential hypertension (n = 36) and PA (n = 50) who were referred to the outpatient hypertension clinic and matched healthy subjects (n = 10) are investigated.

RESULTS:

Statistically significant changes (p < 0.05 ANOVA, Fc > 1.5) of metabolites involved in central carbon, energy, and nitrogen metabolism are identified, especially purine and pyrimidine nucleosides and precursors, and free amino acids. PLS-DA interpretation provides strong evidence of a disease-specific metabolic pattern with dAMP, diiodothyronine, and 5-methoxytryptophan as leading factors, and a sex-specific metabolic pattern associated with orotidine 5-phosphate, N-acetylalanine, hydroxyproline, and cysteine. The results are verified using an independent sample set, which confirms the identification of specific signatures.

CONCLUSIONS AND CLINICAL RELEVANCE:

Metabolomics is used to identify low molecular weight molecular markers of PA, which paves the way for follow-up validation studies in larger cohorts.

KEYWORDS:

aldosterone-producing adenoma; aldosterone-to-renin ratio; hypertension; primary aldosteronism; urinary metabolomics

PMID:
30580498
DOI:
10.1002/prca.201800049

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center