title: A serum metabolomic analysis for diagnosis and biomarker discovery of primary biliary cirrhosis and autoimmune hepatitis.
abstract: BACKGROUND
  Because of the diversity of the clinical and laboratory manifestations, the diagnosis of autoimmune liver disease (AILD) remains a challenge in clinical practice. The value of metabolomics has been studied in the diagnosis of many diseases. The present study aimed to determine whether the metabolic profiles, based on ultraperformance liquid chromatography-mass spectrometry (UPLC-MS), differed between autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC), to identify specific metabolomic markers, and to establish a model for the diagnosis of AIH and PBC.
  
  
  METHODS
  Serum samples were collected from 20 patients with PBC, 19 patients with AIH, and 25 healthy individuals. UPLC-MS data of the samples were analyzed using principal component analysis, partial least squares discrimination analysis and orthogonal partial least squares discrimination analysis.
  
  
  RESULTS
  The partial least squares discrimination analysis model (R2Y=0.991, Q2=0.943) was established between the AIH and PBC groups and exhibited both sensitivity and specificity of 100%. Five groups of biomarkers were identified, including bile acids, free fatty acids, phosphatidylcholines, lysolecithins and sphingomyelin. Bile acids significantly increased in the AIH and PBC groups compared with the healthy control group. The other biomarkers decreased in the AIH and PBC groups compared with those in the healthy control group. In addition, the biomarkers were downregulated in the AIH group compared with the PBC group.
  
  
  CONCLUSIONS
  The biomarkers identified revealed the pathophysiological changes in AILD and helped to discriminate between AIH and PBC. The predictability of this method suggests its potential application in the diagnosis of AILD.
authors.affiliation: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases; State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. Email:hzhuangchina@sina.com.
authors.forename: Jiang-Shan
authors.initials: JS
authors.lastname: Lian
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Shao-Rui
authors.initials: SR
authors.lastname: Hao
authors.forename: Dde-Ying
authors.initials: DY
authors.lastname: Chen
authors.forename: Yin-Yin
authors.initials: YY
authors.lastname: Wang
authors.forename: Jian-Le
authors.initials: JL
authors.lastname: Yang
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Jia
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002853:Chromatography, Liquid; D003937:Diagnosis, Differential; D005260:Female; D019693:Hepatitis, Autoimmune / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D016018:Least-Squares Analysis; D008105:Liver Cirrhosis, Biliary / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D013058:Mass Spectrometry; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D011379:Prognosis; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers