UPM Institutional Repository

Exploring metabolic signature of protein energy wasting in hemodialysis patients


Pauzi, Fatin Athirah and Sahathevan, Sharmela and Khor, Ban Hock and Narayanan, Sreelakshmi Sankara and Zakaria, Nor Fadhlina and Abas, Faridah and Karuppiah, Thilakavathy and Mat Daud, Zulfitri 'Azuan (2020) Exploring metabolic signature of protein energy wasting in hemodialysis patients. Metabolites, 10 (7). pp. 1-16. ISSN 2218-1989


End-stage renal disease patients undergoing maintenance hemodialysis (HD) are vulnerable to the protein energy wasting (PEW) syndrome. Identification and diagnosis of PEW relies on clinical processes of judgment dependent on fulfilling multiple criteria drawn from serum biochemistry, weight status, predictive muscle mass, dietary energy and protein intakes. Therefore, we sought to explore the biomarkers' signature with plasma metabolites of PEW by using 1H-nuclear magnetic resonance for an untargeted metabolomics approach in the HD population, to understand metabolic alteration of PEW. In this case-controlled study, a total of 53 patients undergoing chronic HD were identified having PEW based on established diagnostic criteria and were age- and sex-matched with non-PEW (n = 53) HD patients. Fasting predialysis plasma samples were analyzed. Partial least square discriminant analysis demonstrated a significant separation between groups for specific metabolic pattern alterations. Further quantitative analysis showed that the level of 3-hydroxybutyrate, acetate, arabinose, maltose, ribose, sucrose and tartrate were significantly increased whilst creatinine was significantly decreased (all p < 0.05) in PEW subjects. Pathway analysis indicated that PEW-related metabolites reflected perturbations in fatty acid mechanism and induction of glyoxylate and dicarboxylate pathway attributed to gluconeogenesis. These results provide preliminary data in understanding metabolic alteration of PEW and corresponding abnormal metabolites that could potentially serve as biomarkers of PEW.

Download File

[img] Text (Abstract)

Download (9kB)
Official URL or Download Paper: https://pubmed.ncbi.nlm.nih.gov/32708829/

Additional Metadata

Item Type: Article
Divisions: Faculty of Food Science and Technology
Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.3390/metabo10070291
Publisher: Multidisciplinary Digital Publishing Institute
Keywords: Protein energy wasting; Hemodialysis; Metabolomics; 1H-NMR; Metabolic pathways; Plasma metabolites
Depositing User: Ms. Nuraida Ibrahim
Date Deposited: 04 Oct 2021 23:51
Last Modified: 04 Oct 2021 23:51
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.3390/metabo10070291
URI: http://psasir.upm.edu.my/id/eprint/88910
Statistic Details: View Download Statistic

Actions (login required)

View Item View Item