Urine metabolomic profile in neonates with hypoxic-ischemic encephalopa-thy

Abstract

Background: Metabolomics could provide valuable insights into hypoxemic-ischemic encephalopathy (HIE) revealing new disease-associated biochemical derangements. The study aimed to investigate urine metabolic changes in neonates with HIE compared to healthy controls, using targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS).

Patients and methods: In this prospective, single-center study we enrolled neonates born at ≥ 36 weeks gestation with HIE (HIE group) and healthy controls (control group). We collected urine samples for metabolomic analysis on days one, three, and nine of life.

Results: Twenty-one full-term newborns were studied, 13 in the HIE group and eight in the control group. Six of the affected neonates had moderate/severe HIE and seven mild HIE. Therapeutic hypothermia was applied only in four neonates with moderate/severe HIE. Multivariate and univariate statistical analysis showed a clear separation between the HIE and the control groups. Discriminant metabolites involved pyruvic acid, amino acids, acylcarnitines, inositol, kynurenine, hippuric acid, and vitamins.

Conclusions: We have identified a specific metabolic profile in neonates with HIE, adding to the existing knowledge on the disease biochemistry that may potentially help in biomarker development. HIPPOKRATIA 2017, 21(2): 80-84.

Keywords: brain injury; encephalopathy; metabolomics; neonate; perinatal asphyxia.

Figure 1. Partial least squares-Discriminant Analysis (PLSDA) scores plots in the first two components [t1] and [t2] on days 1, 3 and 9 with the permutation tests performed to validate the grouping in corresponding insets (bottom right of each plot). Hypoxic-ischemic encephalopathy (HIE) samples are differentiated from controls in days 1 and 3, but group separation is not valid on day 9 (permutation fails).