Plasma and stool metabolomic biomarkers of non-alcoholic fatty liver disease in Argentina

Background: Non-invasive biomarkers are urgently needed to identify patients with non-alcoholic fatty liver disease (NAFLD) at risk of disease progression, particularly in high prevalence areas such as Latin America. In this regard, targeted metabolomics is a powerful technology for discovering new gut microbiome-derived metabolites. Thus, we aimed to identify potential metabolomic biomarkers related to NAFLD stage in Argentina, and to assess their relationship with clinical and host genetic factors. Methods: Adult healthy volunteers (HV) and biopsy-proven simple steatosis (SS) or non-alcoholic steatohepatitis (NASH) patients were recruited. Demographic, clinical and food frequency consumption data, as well as plasma and stool samples were collected. SNP rs738409 (PNPLA3 gene) was determined in all volunteers. HPLC and flow injection analysis with MS/MS in tandem was applied for metabolomic studies using the MxP Quant 500 Kit (Biocrates Life Sciences AG, Austria). Significantly different metabolites among groups were identified with MetaboAnalyst v4.0. Bivariate and multivariate analyses were used to identify variables that were independently related to NAFLD stage. Forward stepwise logistic regression models were constructed to design the best feature combination that could distinguish between study groups. Receiver Operating Characteristic (ROC) curves were used to evaluate models? accuracy.Results: 19 HV, 12 SS and 22 NASH patients were recruited. Diet was similar between groups. The concentration of 33 out of 424 detected metabolites (25 in plasma and 8 in stool) was significantly different among study groups. Levels of triglycerides (TG) were higher among NAFLD patients, whereas levels of phosphatidylcholines (PC) and lysoPC were higher among HV. The PNPLA3 risk genotype for NAFLD and NASH (GG) was related to higher plasma levels of eicosenoic acid FA(20:1) (p<0.001). Plasma metabolites showed a higher accuracy for diagnosis of NAFLD and NASH when compared to stool metabolites (Table 1). Body mass index (BMI) and plasma levels of PC aa C24:0, FA(20:1) and TG(16:1_34:1) showed high accuracy for diagnosis of NAFLD; whereas the best AUROC for discriminating NASH from SS was that of plasma levels of PC aa C24:0 and PC ae C40:1 (Table 1).Conclusions: Gut microbiome-derived metabolomic biomarkers were identified in plasma and stool, but plasma metabolites were better diagnostic biomarkers of NAFLD and NASH in Argentina. Further validation studies are needed.Fil: Mazzini, Flavia Noelia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Cook, Frank. Novartis Institutes For Biomedical Research; Estados UnidosFil: Gounarides, John. Novartis Institutes For Biomedical Research; Estados UnidosFil: Marciano, Sebastian. Hospital Italiano; ArgentinaFil: Haddad, Leila. Hospital Italiano; ArgentinaFil: Tamaroff, Ana Jesica. Hospital Italiano; ArgentinaFil: Casciato, Paola. Hospital Italiano; ArgentinaFil: Narvaez, Adriana Haydée. Hospital Italiano; ArgentinaFil: Mascardi, María Florencia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Anders, Margarita. Hospital Alemán; ArgentinaFil: Orozco, Federico. Hospital Alemán; ArgentinaFil: Quiroz, Nicolas. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Risk, Marcelo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Gutt, Susana. Hospital Italiano; ArgentinaFil: Gadano, Adrián Carlos. Hospital Italiano; ArgentinaFil: Mendez Garcia, Celia. Hospital Italiano; ArgentinaFil: Marro, Martin. Novartis Institutes For Biomedical Research; Estados UnidosFil: Penas Steinhardt, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Estudios de la Inmunidad Humoral Prof. Ricardo A. Margni; ArgentinaFil: Trinks, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional e Ingeniería Biomédica - Hospital Italiano. Instituto de Medicina Traslacional e Ingeniería Biomédica.- Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional e Ingeniería Biomédica; ArgentinaThe Liver Meeting Digital ExperienceEstados UnidosAmerican Association for the Study of the Liver Diseas

Plasma and stool metabolomic biomarkers of non-alcoholic fatty liver disease in Argentina

Non-invasive biomarkers are urgently needed to identify NAFLD patients at risk of progression to non-alcoholic steatohepatitis (NASH), particularly in high prevalence areas such as Latin America. Thus, we aimed to identify potential metabolomic biomarkers related to NAFLD stage in Argentina, and to assess their relationship with clinical and host genetic factors.Healthy volunteers (n=19) and biopsy-proven simple steatosis (n=12) or non-alcoholic steatohepatitis (n=22) patients with similar food intake data were recruited. Plasma and stool samples, as well as demographic and clinical data were collected. SNP rs738409 (PNPLA3 gene) was determined in all volunteers. HPLC and flow injection analysis with MS/MS in tandem was applied for metabolomic studies using the MxP Quant 500 Kit (Biocrates Life Sciences AG, Austria) and MetaboAnalyst v4.0. Bivariate and multivariate analyses identified variables independently related to NAFLD stage. Forward stepwise logistic regression models were constructed to diagnose NAFLD and NASH. ROC curves were used to evaluate models? accuracy.The concentration of 33 out of the 424 detected metabolites (25 in plasma and 8 in stool) significantly differed among groups. Levels of triglycerides (TG) were higher among NAFLD patients, whereas levels of phosphatidylcholines (PC) and lysoPC were lower among them. The PNPLA3 risk genotype was related to higher plasma levels of eicosenoic acid FA(20:1) (p<0.001). Plasma metabolites showed a higher accuracy for diagnosis of NAFLD and NASH (AUROC=1) than stool metabolites (AUROC=0.79 and 0.90, respectively). Body mass index and plasma levels of PC aa C24:0, FA(20:1) and TG(16:1_34:1) showed high accuracy for diagnosis of NAFLD (AUROC=1); whereas plasma levels of PC aa C24:0 and PC ae C40:1 showed AUROC=1 for discriminating NAFLD stages.In conclusion, potential metabolomic biomarkers for diagnosis and progression of NAFLD were identified in Argentina. Further validation studies are needed.Fil: Mazzini, Flavia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Cook, Frank. Novartis Institutes For Biomedical Research; Estados UnidosFil: Gounarides, John. Novartis Institutes For Biomedical Research; Estados UnidosFil: Marciano, Sebastian. Hospital Italiano; ArgentinaFil: Haddad, Leila. Hospital Italiano; ArgentinaFil: Tamaroff, Ana Jesica. Hospital Italiano; ArgentinaFil: Casciato, Paola. Hospital Italiano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Narvaez, Adriana Haydée. Hospital Italiano; ArgentinaFil: Mascardi, Maria Florencia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Anders, Margarita. Hospital Alemán; ArgentinaFil: Orozco, F.. Hospital Alemán; ArgentinaFil: Quiroz, Nicolas. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Risk, Marcelo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaFil: Gutt, Susana. Hospital Italiano; ArgentinaFil: Gadano, Adrián. Hospital Italiano; ArgentinaFil: Méndez García, Celia. Novartis Institutes For Biomedical Research; Estados UnidosFil: Marro, Martin. Novartis Institutes For Biomedical Research; Estados UnidosFil: Penas Steinhardt, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Lujan. Departamento de Cs.basicas. Laboratorio de Genomica Computacional.; ArgentinaFil: Trinks, Julieta. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Hospital Italiano. Instituto de Medicina Traslacional E Ingenieria Biomedica. - Instituto Universitario Hospital Italiano de Buenos Aires. Instituto de Medicina Traslacional E Ingenieria Biomedica.; ArgentinaReunión Anual de Sociedades de BiocienciasArgentinaSociedad Argentina de Investigación ClínicaSociedad Argentina de InmunologíaSociedad Argentina de Fisiologí