title: Urinary 1H-NMR metabolomics can distinguish pancreatitis patients from healthy controls.
abstract: BACKGROUND
  The characterization of the urinary metabolome may yield biomarkers indicative of pancreatitis.
  
  
  OBJECTIVE
  We establish a non-invasive technique to compare urinary metabolic profiles in patients with acute and chronic pancreatitis to healthy controls.
  
  
  METHODS
  Urine was obtained from healthy controls (HC, n=5), inpatients with mild acute pancreatitis (AP, n=5), and outpatients with chronic pancreatitis (CP, n=5). Proton nuclear magnetic resonance spectra were obtained for each sample. Metabolites were identified and quantified in each spectrum; resulting concentrations were normalized to account for differences in dilution among samples. Kruskal-Wallis test, post-hoc Mann-Whitney U tests, and principal component analysis were performed to identify metabolites that discriminate healthy controls, acute pancreatitis, and chronic pancreatitis.
  
  
  RESULTS
  Sixty metabolites were identified and quantified; five were found to differ significantly (P&lt;0.05) among the three groups. Of these, citrate and adenosine remained significant after validation by random permutation. Principal component analysis demonstrated that healthy control urine samples can be differentiated from patients with chronic pancreatitis or acute pancreatitis; chronic pancreatitis patients could not be distinguished from acute pancreatitis patients.
  
  
  CONCLUSIONS
  This metabolomic investigation demonstrates that this non-invasive technique offers insight into the metabolic states of pancreatitis. Although the identified metabolites cannot conclusively be defined as biomarkers of disease, future studies will validate our findings in larger patient cohorts.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA. lusc0006@umn.edu
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Lusczek
authors.forename: Joao A
authors.initials: JA
authors.lastname: Paulo
authors.forename: John R
authors.initials: JR
authors.lastname: Saltzman
authors.forename: Vivek
authors.initials: V
authors.lastname: Kadiyala
authors.forename: Peter A
authors.initials: PA
authors.lastname: Banks
authors.forename: Greg
authors.initials: G
authors.lastname: Beilman
authors.forename: Darwin L
authors.initials: DL
authors.lastname: Conwell
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006262:Health; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D055442:Metabolome / Q000502:physiology; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000378:metabolism / Q000652:urine*; D011522:Protons; D016482:Urinalysis / Q000379:methods; D054928:Validation Studies as Topic; D055815:Young Adult
chemical_list: D011522:Protons