title: Urinary NMR metabolomic profiles discriminate inflammatory bowel disease from healthy.
abstract: OBJECTIVE
  Inflammatory bowel disease, a chronic inflammation of the intestinal tract, presents in two variations, Ulcerative Colitis (UC) and Crohn's disease (CD). Given that treatment of CD differs from UC, a single test that provided strong diagnostic ability would offer great clinical value. Two previous studies have indicated that CD can be distinguished from UC, and that both can be distinguished from non-IBD-type gastrointestinal disease, based on urinary and faecal metabolite profiling.
  
  
  METHODS
  Analysis of healthy as well as CD and UC patients attending an IBD clinic was performed. IBD patients were classified into two groups (CD or UC) based on chart review of clinical, endoscopic, and histological assessment. Urine samples were obtained and analyzed using nuclear magnetic resonance (NMR) spectroscopy combined with targeted profiling techniques, followed by univariate and multivariate statistical analysis.
  
  
  RESULTS
  Based on urinary metabolomics, individuals with IBD could be differentiated from healthy. Major differences between IBD and healthy included TCA cycle intermediates, amino acids, and gut microflora metabolites. Comparison of CD and UC patients revealed discrimination, but removal of patients with the surgical intervention confounder revealed that CD could not be discriminated from UC.
  
  
  CONCLUSIONS
  This study highlights the potential for metabolomics to distinguish IBD from the healthy state but shows that careful consideration must be given to establishing disease-representative cohorts that are free of confounding factors.
authors.affiliation: Department of Food Science & Technology, University of California, Davis, Davis, CA 95616, USA.
authors.forename: Natasha S
authors.initials: NS
authors.lastname: Stephens
authors.forename: Jesse
authors.initials: J
authors.lastname: Siffledeen
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Su
authors.forename: Travis B
authors.initials: TB
authors.lastname: Murdoch
authors.forename: Richard N
authors.initials: RN
authors.lastname: Fedorak
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Slupsky
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000652:urine*; D003424:Crohn Disease / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D055442:Metabolome; D008875:Middle Aged; D019906:Nuclear Magnetic Resonance, Biomolecular; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult