{Reference Type}: Clinical Trial
{Title}: Urinary Metabolic Signature of Primary Aldosteronism: Gender and Subtype-Specific Alterations.
{Author}: Lana A;Alexander K;Castagna A;D'Alessandro A;Morandini F;Pizzolo F;Zorzi F;Mulatero P;Zolla L;Olivieri O;
{Journal}: Proteomics Clin Appl
{Volume}: 13
{Issue}: 4
{Year}: 07 2019
{Factor}: 3.603
{DOI}: 10.1002/prca.201800049
{Abstract}: The current clinical investigation for primary aldosteronism (PA) diagnosis requires complex expensive tests from the initial suspicion to the final subtype classification, including invasive approaches; therefore, appropriate markers for subtype definition are greatly desirable. The present study performs a metabolomics analysis to further examine specific molecular signatures of PA urines EXPERIMENTAL DESIGN: The study considered PA subtype and gender-related differences using two orthogonal advanced UHPLC-MS metabolomics approaches. Patients with essential hypertension (n = 36) and PA (n = 50) who were referred to the outpatient hypertension clinic and matched healthy subjects (n = 10) are investigated.<BR>Statistically significant changes (p < 0.05 ANOVA, Fc > 1.5) of metabolites involved in central carbon, energy, and nitrogen metabolism are identified, especially purine and pyrimidine nucleosides and precursors, and free amino acids. PLS-DA interpretation provides strong evidence of a disease-specific metabolic pattern with dAMP, diiodothyronine, and 5-methoxytryptophan as leading factors, and a sex-specific metabolic pattern associated with orotidine 5-phosphate, N-acetylalanine, hydroxyproline, and cysteine. The results are verified using an independent sample set, which confirms the identification of specific signatures.<BR>Metabolomics is used to identify low molecular weight molecular markers of PA, which paves the way for follow-up validation studies in larger cohorts.