Clinical metabolomics and hematic ADMA predict the future onset of cardiorenal syndrome in young grown-up subjects who were born preterm

Abstract

Objectives: To look for differences in the urinary metabolic profile and in the hematic asymmetric dimethylarginine (ADMA) levels between a group of young adults born preterm with an extremely low birthweight (<1000 g; ex-ELBW; n=19) and a control group of subjects born at term with a weight appropriate for their gestational age (AGA; n=13); and to look for a possible correlation between the urinary metabolic profile in ex-ELBW and their hematic levels of ADMA.

Design and methods: Urine samples were analyzed by (1)H nuclear magnetic resonance spectroscopy, and then submitted to unsupervised and supervised multivariate analysis. Samples of blood were collected and ADMA concentration was assessed by high-performance liquid chromatography.

Results: Using supervised PLS-DA (partial least squares discriminant analysis) model, the authors were able to discriminate between ex-ELBW and AGA. Statistically significant differences were detected in the ADMA levels between ex-ELBW and AGA (p<0.02). Ex-ELBW metabolic profile correlated with ADMA concentrations (r=0.456, p<0.05). Conversely, ADMA levels in AGA did not correlated with their metabolic profiles.

Conclusions: This study demonstrates the relevance of the metabolomic technique as a predictive tool of the metabolic status in ex-ELBW. The relationship between ex-ELBW urinary metabolic profile and their blood ADMA levels suggests the presence of a subclinical cardio-renal involvement in these subjects.

Keywords: Asymmetric dimethylarginine; Cardio-renal syndrome; Heart; Kidney; Metabolomics; Prematurity.