title: The metabolomics of necrotising enterocolitis in preterm babies: an exploratory study.
abstract: OBJECTIVE
  No single diagnostic investigation is currently available for necrotising enterocolitis (NEC). We implemented a novel, untargeted, exploratory study to determine whether metabolomics can reveal early biomarker(s) of NEC. The effect of gestational age on the metabolome was also investigated.
  
  
  METHODS
  Two serum samples were obtained from 12 preterm babies (born <30 weeks gestation) and eight term controls: sample "A" at ≤1 week of age and sample "B" once fully fed. Samples were subjected to gas chromatography-mass spectrometry. Metabolomic data was analysed by principal component analysis (PCA), univariate and network analysis.
  
  
  RESULTS
  Sixteen metabolite features significantly differed when B samples were compared between preterm babies who subsequently developed NEC and preterm/term controls (p value <0.05). Of these seven metabolites were linked to up-regulation of IL-1β. Significant differences in 54 metabolite features (p value <0.05) were observed between preterm and term metabolomes. Of these, 12 metabolite features were linked to one network involved in carbohydrate/lipid metabolism (p = 1 × 10(-30)).
  
  
  CONCLUSIONS
  Metabolomic differences were observed in preterm babies at risk of NEC. However, sample sizes were insufficient to confidently identify a biomarker. Network modelling of preterm and term metabolomes suggest possible nutritional deficiency and altered pro-insulin action in preterm babies.
authors: a Faculty of Medical and Human Sciences , University of Manchester , Manchester , UK .
authors: Amy
authors: A
authors: Wilcock
authors: b Faculty of Medical and Human Sciences , Centre for Endocrinology and Diabetes, Institute of Human Development, The University of Manchester , Manchester , UK .|c Centre for Advanced Discovery and Experimental Therapeutics (CADET), Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre , Manchester , UK .
authors: Paul
authors: P
authors: Begley
authors: d Faculty of Medical and Human Sciences , Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester , Manchester , UK .|e Manchester Academic Health Sciences Centre (MAHSC), Central Manchester University Hospitals NHS Foundation Trust , Manchester , UK , and.
authors: Adam
authors: A
authors: Stevens
authors: d Faculty of Medical and Human Sciences , Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester , Manchester , UK .|e Manchester Academic Health Sciences Centre (MAHSC), Central Manchester University Hospitals NHS Foundation Trust , Manchester , UK , and.
authors: Andrew
authors: A
authors: Whatmore
authors: d Faculty of Medical and Human Sciences , Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester , Manchester , UK .|e Manchester Academic Health Sciences Centre (MAHSC), Central Manchester University Hospitals NHS Foundation Trust , Manchester , UK , and.|f Neonatology Center of Excellence, Sidra Medical and Research Center , Doha , Qatar.
authors: Suresh
authors: S
authors: Victor
mesh_terms: D015415:Biomarkers / Q000097:blood*; D001774:Blood Chemical Analysis / Q000379:methods; D016022:Case-Control Studies; D042241:Early Diagnosis; D020345:Enterocolitis, Necrotizing / Q000097:blood / Q000151:congenital / Q000175:diagnosis*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis*; D008297:Male; D055442:Metabolome; D055432:Metabolomics
chemical_list: D015415:Biomarkers
keywords: Biomarker; metabolomics; necrotising enterocolitis; preterm; term