title: Changes in serum metabolites with the stage of chronic kidney disease: Comparison of diabetes and non-diabetes.
abstract: BACKGROUND
  The renal dysfunction of chronic kidney disease (CKD) alters serum metabolite levels, but it is not clear how diabetes mellitus (DM) affects the metabolic changes in CKD.
  
  
  METHODS
  Serum metabolites from pre-dialysis CKD patients (n=291) with or without DM and from healthy controls (n=56) was measured using nuclear magnetic resonance.
  
  
  RESULTS
  Initial principal components analysis and partial least squares-discriminant analysis score plots segregated the CKD patients according to CKD stage and separated DM from non-DM patients. In the CKD patients, associations were seen with clinical characteristics, hyperglycemia, altered amino acid metabolism, accumulated uremic toxins, and dyslipidemia. Of interest, diabetes more strongly affected the metabolic signature during early stage CKD. Furthermore, serum metabolite profiles were successfully applied to the PLS regression model to predict the estimated glomerular filtration rate. The R(2) values from the PLS models for CKD patients with DM were higher than those for CKD without DM.
  
  
  CONCLUSIONS
  Metabolomics is useful clinically for providing a metabolic signature that is associated with the CKD phenotype and diabetes more seriously affects patients with early stage CKD compared to those with advanced CKD.
authors.affiliation: Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Republic of Korea; Department of Chemistry, Sungkyunkwan University, Suwon 16419, Republic of Korea.
authors.forename: Jueun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130, Dongduk-ro, Jung-gu, Daegu 41944, Republic of Korea.
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Republic of Korea.
authors.forename: Yong-Kook
authors.initials: YK
authors.lastname: Kwon
authors.affiliation: Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Republic of Korea; Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon, Republic of Korea.
authors.forename: Doohae
authors.initials: D
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130, Dongduk-ro, Jung-gu, Daegu 41944, Republic of Korea.
authors.forename: Hee-Yeon
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130, Dongduk-ro, Jung-gu, Daegu 41944, Republic of Korea.
authors.forename: Hye-Myung
authors.initials: HM
authors.lastname: Ryu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130, Dongduk-ro, Jung-gu, Daegu 41944, Republic of Korea.
authors.forename: Jang-Hee
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Chemistry, Sungkyunkwan University, Suwon 16419, Republic of Korea. Electronic address: dhryu@skku.edu.
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Ryu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130, Dongduk-ro, Jung-gu, Daegu 41944, Republic of Korea. Electronic address: ylkim@knu.ac.kr.
authors.forename: Yong-Lim
authors.initials: YL
authors.lastname: Kim
authors.affiliation: Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Republic of Korea; Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon, Republic of Korea; Department of Chemistry and Nano Science, Ewha Womans University, Seoul, Republic of Korea. Electronic address: gshwang@kbsi.re.kr.
authors.forename: Geum-Sook
authors.initials: GS
authors.lastname: Hwang
mesh_terms: D003920:Diabetes Mellitus / Q000097:blood* / Q000378:metabolism*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000378:metabolism*
keywords: Chronic kidney disease; Diabetes mellitus; Metabolite profiling; Nuclear magnetic resonance spectroscopy