title: Diagnosing diabetic nephropathy by 1H NMR metabonomics of serum.
abstract: OBJECTIVE
  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 (1)H NMR metabonomics of serum in a diagnostic fashion.
  
  
  METHODS
  182 T1DM and 21 non-diabetic (non-T1DM) individuals were studied. The (1)H 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 (1)H NMR. For diabetic nephropathy diagnosis in the T1DM patients, (1)H 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
  (1)H 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.
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland. vmakine2@lce.hut.fi
authors.forename: Ville-Petteri
authors.initials: VP
authors.lastname: Mäkinen
authors.forename: Pasi
authors.initials: P
authors.lastname: Soininen
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Maija
authors.initials: M
authors.lastname: Parkkonen
authors.forename: Petri
authors.initials: P
authors.lastname: Ingman
authors.forename: Kimmo
authors.initials: K
authors.lastname: Kaski
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
authors.forename: Mika
authors.initials: M
authors.lastname: Ala-Korpela
mesh_terms: D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods*; D001798:Blood Proteins / Q000032:analysis*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D020543:Proteome / Q000032:analysis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D020543:Proteome