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Zhang X, Zhou J, Xie Z, Li X, Hu J, He H, Li Z. Exploring blood metabolites and thyroid disorders: a bidirectional mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1270336. [PMID: 37876541 PMCID: PMC10591305 DOI: 10.3389/fendo.2023.1270336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Abstract
Background Human blood metabolites have demonstrated close associations with thyroid disorders in observational studies. However, it's essential to determine whether these correlations imply causation. Mendelian Randomization (MR) offers a promising approach to investigate these patterns. Aims The primary aim of our investigation is to establish causality between blood metabolites and three thyroid disorders: TC, GD, and HT. Methods We employed a two-sample bidirectional MR analysis approach to assess the relationships between 452 blood metabolites and the three aforementioned thyroid disorders. Causal links were estimated using the IVW method, with sensitivity analyses conducted via MR-Egger, Weighted Median, and MR-PRESSO. We assessed potential heterogeneity and pleiotropy using MR-Egger intercept and Cochran's Q statistic. Additionally, we conducted pathway analysis to identify potential metabolic pathways. Results We found 46 metabolites that showed suggestive associations with thyroid disease risk, especially Aspartate (ORIVW=7.41; 95%CI: 1.51-36.27; PIVW=0.013) and C-glycosyltryptophan (ORIVW=0.04; 95%CI: 0.00-0.29; PIVW=0.001) impacted TC, Kynurenine (ORIVW=2.69; 95%CI: 1.08-6.66; PIVW=0.032) and 4-androsten-3beta,17beta-diol disulfate 2 (ORIVW=0.78; 95%CI: 0.48-0.91; PIVW=0.024) significantly impacted GD, and Alpha-ketoglutarate (ORIVW=46.89; 95%CI: 4.65-473.28; PIVW=0.001) and X-14189-leucylalanine (ORIVW=0.31; 95%CI: 0.15-0.64 PIVW=0.001) significantly impacted HT. We also detected 23 metabolites influenced by TC and GD. Multiple metabolic pathways have been found to be involved in thyroid disease. Conclusion Our MR findings suggest that the identified metabolites and pathways can serve as biomarkers for clinical thyroid disorder screening and prevention, while also providing new insights for future mechanistic exploration and drug target selection.
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Affiliation(s)
- Xuan Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
- Department of General Surgery, The Second People’s Hospital of Hunan, Changsha, Hunan, China
| | - Jiating Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Zilan Xie
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Xi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Jiaqing Hu
- Department of Emergency Medicine, Trauma Center, The Second People’s Hospital of Hunan, Changsha, Hunan, China
| | - Hengzheng He
- Department of General Surgery, The Second People’s Hospital of Hunan, Changsha, Hunan, China
| | - Zhi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
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Lee HY, Sim BC, Nga HT, Moon JS, Tian J, Linh NT, Ju SH, Choi DW, Setoyama D, Yi HS. Metabolite Changes during the Transition from Hyperthyroidism to Euthyroidism in Patients with Graves' Disease. Endocrinol Metab (Seoul) 2022; 37:891-900. [PMID: 36604959 PMCID: PMC9816501 DOI: 10.3803/enm.2022.1590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/28/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGRUOUND An excess of thyroid hormones in Graves' disease (GD) has profound effects on systemic energy metabolism that are currently partially understood. In this study, we aimed to provide a comprehensive understanding of the metabolite changes that occur when patients with GD transition from hyperthyroidism to euthyroidism with methimazole treatment. METHODS Eighteen patients (mean age, 38.6±14.7 years; 66.7% female) with newly diagnosed or relapsed GD attending the endocrinology outpatient clinics in a single institution were recruited between January 2019 and July 2020. All subjects were treated with methimazole to achieve euthyroidism. We explored metabolomics by performing liquid chromatography-mass spectrometry analysis of plasma samples of these patients and then performed multivariate statistical analysis of the metabolomics data. RESULTS Two hundred metabolites were measured before and after 12 weeks of methimazole treatment in patients with GD. The levels of 61 metabolites, including palmitic acid (C16:0) and oleic acid (C18:1), were elevated in methimazole-naïve patients with GD, and these levels were decreased by methimazole treatment. The levels of another 15 metabolites, including glycine and creatinine, were increased after recovery of euthyroidism upon methimazole treatment in patients with GD. Pathway analysis of metabolomics data showed that hyperthyroidism was closely related to aminoacyl-transfer ribonucleic acid biosynthesis and branched-chain amino acid biosynthesis pathways. CONCLUSION In this study, significant variations of plasma metabolomic patterns that occur during the transition from hyperthyroidism to euthyroidism were detected in patients with GD via untargeted metabolomics analysis.
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Affiliation(s)
- Ho Yeop Lee
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Byeong Chang Sim
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ha Thi Nga
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ji Sun Moon
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jingwen Tian
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Nguyen Thi Linh
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Sang Hyeon Ju
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Dong Wook Choi
- Department of Biochemistry, Chungnam National University College of Natural Sciences, Daejeon, Korea
| | - Daiki Setoyama
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
- Corresponding authors: Hyon-Seung Yi. Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: +82-42-280-6994, Fax: +82-42-280-7995, E-mail:
| | - Hyon-Seung Yi
- Laboratory of Endocrinology and Immune System, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Daiki Setoyama. Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Fukuoka 812-8582, Japan Tel: +81-92-642-5752, Fax: +81-92-642-5752, E-mail:
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Liu H, Liu H, Liu C, Shang M, Wei T, Yin P. Gut Microbiome and the Role of Metabolites in the Study of Graves’ Disease. Front Mol Biosci 2022; 9:841223. [PMID: 35252357 PMCID: PMC8889015 DOI: 10.3389/fmolb.2022.841223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
Graves’ disease (GD) is an autoimmune thyroid disease (AITD), which is one of the most common organ-specific autoimmune disorders with an increasing prevalence worldwide. But the etiology of GD is still unclear. A growing number of studies show correlations between gut microbiota and GD. The dysbiosis of gut microbiota may be the reason for the development of GD by modulating the immune system. Metabolites act as mediators or modulators between gut microbiota and thyroid. The purpose of this review is to summarize the correlations between gut microbiota, microbial metabolites and GD. Challenges in the future study are also discussed. The combination of microbiome and metabolome may provide new insight for the study and put forward the diagnosis, treatment, prevention of GD in the future.
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Affiliation(s)
- Haihua Liu
- Clinical Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Huiying Liu
- Clinical Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Chang Liu
- Clinical Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Mengxue Shang
- Clinical Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Tianfu Wei
- Clinical Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Institute of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Peiyuan Yin
- Clinical Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Peiyuan Yin, ,
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Setoyama D, Lee HY, Moon JS, Tian J, Kang YE, Lee JH, Shong M, Kang D, Yi H. Immunometabolic signatures predict recovery from thyrotoxic myopathy in patients with Graves' disease. J Cachexia Sarcopenia Muscle 2022; 13:355-367. [PMID: 34970859 PMCID: PMC8818593 DOI: 10.1002/jcsm.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 10/14/2021] [Accepted: 11/22/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Thyroid hormone excess induces protein energy wasting, which in turn promotes muscle weakness and bone loss in patients with Graves' disease. Although most studies have confirmed a relationship between thyrotoxicosis and muscle dysfunction, few have measured changes in plasma metabolites and immune cells during the development and recovery from thyrotoxic myopathy. The aim of this study was to identify specific plasma metabolites and T-cell subsets that predict thyrotoxic myopathy recovery in patients with Graves' disease. METHODS One hundred patients (mean age, 40.0 ± 14.2 years; 67.0% female), with newly diagnosed or relapsed Graves' disease were enrolled at the start of methimazole treatment. Handgrip strength and Five Times Sit to Stand Test performance time were measured at Weeks 0, 12, and 24. In an additional 35 patients (mean age, 38.9 ± 13.5 years; 65.7% female), plasma metabolites and immunophenotypes of peripheral blood were evaluated at Weeks 0 and 12, and the results of a short physical performance battery assessment were recorded at the same time. RESULTS In both patient groups, methimazole-induced euthyroidism was associated with improved handgrip strength and lower limb muscle function at 12 weeks. Elevated plasma metabolites including acylcarnitines were restored to normal levels at Week 12 regardless of gender, body mass index, or age (P trend <0.01). Senescent CD8+ CD28- CD57+ T-cell levels in peripheral blood were positively correlated with acylcarnitine levels (P < 0.05) and decreased during thyrotoxicosis recovery (P < 0.05). High levels of senescent CD8+ T cells at Week 0 were significantly associated with small increases in handgrip strength after 12 weeks of methimazole treatment (P < 0.05), but not statistically associated with Five Times Sit to Stand Test performance. CONCLUSIONS Restoring euthyroidism in Graves' disease patients was associated with improved skeletal muscle function and performance, while thyroid hormone-associated changes in plasma acylcarnitines levels correlated with muscle dysfunction recovery. T-cell senescence-related systemic inflammation correlated with plasma acylcarnitine levels and was also associated with small increases in handgrip strength.
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Affiliation(s)
- Daiki Setoyama
- Department of Clinical Chemistry and Laboratory MedicineKyushu University HospitalFukuokaJapan
| | - Ho Yeop Lee
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
- Department of Medical ScienceChungnam National University School of MedicineDaejeonKorea
| | - Ji Sun Moon
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
| | - Jingwen Tian
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
- Department of Medical ScienceChungnam National University School of MedicineDaejeonKorea
| | - Yea Eun Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
| | - Ju Hee Lee
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
| | - Minho Shong
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
- Department of Medical ScienceChungnam National University School of MedicineDaejeonKorea
| | - Dongchon Kang
- Department of Clinical Chemistry and Laboratory MedicineKyushu University HospitalFukuokaJapan
- Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hyon‐Seung Yi
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea
- Department of Medical ScienceChungnam National University School of MedicineDaejeonKorea
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Billiet B, Chao de la Barca JM, Ferré M, Muller J, Vautier A, Assad S, Blanchet O, Tessier L, Wetterwald C, Faure J, Urbanski G, Simard G, Mirebeau-Prunier D, Rodien P, Gohier P, Reynier P. A Tear Metabolomic Profile Showing Increased Ornithine Decarboxylase Activity and Spermine Synthesis in Thyroid-Associated Orbitopathy. J Clin Med 2022; 11:jcm11020404. [PMID: 35054098 PMCID: PMC8779711 DOI: 10.3390/jcm11020404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 02/01/2023] Open
Abstract
About half of patients with Graves’ disease develop an orbitopathy related to an inflammatory expansion of the periorbital adipose tissue and muscles. We used a targeted metabolomic approach measuring 188 metabolites by mass spectrometry to compare the metabolic composition of tears in patients with active (n = 21) versus inactive (n = 24) thyroid-associated orbitopathy. Among the 44 metabolites accurately measured, 8 showed a significant alteration of their concentrations between the two groups. Two short-chain acylcarnitines, propionylcarnitine and butyrylcarnitine, and spermine showed increased concentrations in the tears of patients with active orbitopathy, whereas ornithine, glycine, serine, citrulline and histidine showed decreased concentrations in this group. In addition, the ratio putrescine/ornithine, representing the activity of ornithine decarboxylase, was significantly increased in patients with active compared to inactive orbitopathy (p = 0.0011, fold change 3.75). The specificity of this candidate biomarker was maintained when compared to a control group with unclassified dry eye disease. Our results suggest that the stimulation of ornithine decarboxylase by TSH receptor autoantibodies in orbital fibroblasts could lead to increased synthesis of spermine, through the increased activity of ornithine decarboxylase, that may contribute to periorbital expansion in Graves’ ophthalmopathy.
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Affiliation(s)
- Benjamin Billiet
- Département d’Ophtalmologie, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (B.B.); (J.M.); (A.V.); (S.A.); (P.G.)
| | - Juan Manuel Chao de la Barca
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, F-49000 Angers, France; (M.F.); (G.U.); (P.R.)
| | - Marc Ferré
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, F-49000 Angers, France; (M.F.); (G.U.); (P.R.)
| | - Jeanne Muller
- Département d’Ophtalmologie, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (B.B.); (J.M.); (A.V.); (S.A.); (P.G.)
| | - Anaïs Vautier
- Département d’Ophtalmologie, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (B.B.); (J.M.); (A.V.); (S.A.); (P.G.)
| | - Sophie Assad
- Département d’Ophtalmologie, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (B.B.); (J.M.); (A.V.); (S.A.); (P.G.)
| | - Odile Blanchet
- Centre de Ressources Biologiques, BB-0033-00038, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France;
| | - Lydie Tessier
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
| | - Céline Wetterwald
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
| | - Justine Faure
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
| | - Geoffrey Urbanski
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, F-49000 Angers, France; (M.F.); (G.U.); (P.R.)
- Service de Médecine Interne et d’Immunologie Clinique, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France
| | - Gilles Simard
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
| | - Delphine Mirebeau-Prunier
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, F-49000 Angers, France; (M.F.); (G.U.); (P.R.)
| | - Patrice Rodien
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, F-49000 Angers, France; (M.F.); (G.U.); (P.R.)
- Service d’Endocrinologie, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France
| | - Philippe Gohier
- Département d’Ophtalmologie, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (B.B.); (J.M.); (A.V.); (S.A.); (P.G.)
| | - Pascal Reynier
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire (CHU), F-49000 Angers, France; (J.M.C.d.l.B.); (L.T.); (C.W.); (J.F.); (G.S.); (D.M.-P.)
- Unité Mixte de Recherche (UMR) MITOVASC, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d’Angers, F-49000 Angers, France; (M.F.); (G.U.); (P.R.)
- Correspondence:
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Jaber MA, Benabdelkamel H, Dahabiyeh LA, Masood A, AlMalki RH, Musambil M, Alfadda AA, Abdel Rahman AM. The metabolomics approach revealed a distinctive metabolomics pattern associated with hyperthyroidism treatment. Front Endocrinol (Lausanne) 2022; 13:1050201. [PMID: 36440210 PMCID: PMC9685425 DOI: 10.3389/fendo.2022.1050201] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Hyperthyroidism is characterized by increased thyroid hormone production, which impacts various processes, including metabolism and energy expenditure. Yet, the underlying mechanism and subsequent influence of these changes are unknown. Metabolomics is a broad analytical method that enables qualitative and quantitative examination of metabolite level changes in biological systems in response to various stimuli, pathologies, or treatments. OBJECTIVES This study uses untargeted metabolomics to explore the potential pathways and metabolic patterns associated with hyperthyroidism treatment. METHODS The study consisted of 20 patients newly diagnosed with hyperthyroidism who were assessed at baseline and followed up after starting antithyroid treatment. Two blood samples were taken from each patient, pre (hyperthyroid state) and post-treatment (euthyroid state). Hyperthyroid and euthyroid states were identified based on thyroxine and thyroid-stimulating hormone levels. The metabolic alteration associated with antithyroid therapy was investigated using liquid chromatography- high-resolution mass spectrometry. The untargeted metabolomics data was analyzed using both univariate and multivariate analyses using MetaboAnalyst v5.0. The significant metabolic pattern was identified using the lab standard pipeline, which included molecular annotation in the Human Metabolome Database, LipidMap, LipidBlast, and METLIN. The identified metabolites were examined using pathway and network analyses and linked to cellular metabolism. RESULTS The results revealed a strong group separation between the pre- and post-hyperthyroidism treatment (Q2 = 0.573, R2 = 0.995), indicating significant differences in the plasma metabolome after treatment. Eighty-three mass ions were significantly dysregulated, of which 53 and 30 characteristics were up and down-regulated in the post-treatment compared to the pre-treatment group, respectively. The medium-chain acylcarnitines, octanoylcarnitine, and decanoylcarnitine, previously found to rise in hyperthyroid patients, were among the down-regulated metabolites, suggesting that their reduction could be a possible biomarker for monitoring euthyroid restoration. Kynurenine is a downregulated tryptophan metabolite, indicating that the enzyme kynurenine 3-hydroxylase, inhibited in hyperthyroidism, is back functioning. L-cystine, a cysteine dimer produced from cysteine oxidation, was among the down-regulated metabolites, and its accumulation is considered a sign of oxidative stress, which was reported to accompany hyperthyroidism; L-cystine levels dropped, this suggests that the plasma level of L-cystine can be used to monitor the progress of euthyroid state restoration. CONCLUSION The plasma metabolome of patients with hyperthyroidism before and after treatments revealed differences in the abundance of several small metabolites. Our findings add to our understanding of hyperthyroidism's altered metabolome and associated metabolic processes and shed light on acylcarnitines as a new biomarker for treatment monitoring in conjunction with thyroxine and thyroid-stimulating hormone.
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Affiliation(s)
- Malak A. Jaber
- Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Hicham Benabdelkamel
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lina A. Dahabiyeh
- Division of Pharmaceutical Sciences, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Afshan Masood
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reem H. AlMalki
- Metabolomics Section, Department of Clinical Genomics, Center for Genome Medicine, King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Mohthash Musambil
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Assim A. Alfadda
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine and King Saud Medical City, King Saud University, Riyadh, Saudi Arabia
- *Correspondence: Assim A. Alfadda, ; Anas M. Abdel Rahman,
| | - Anas M. Abdel Rahman
- Metabolomics Section, Department of Clinical Genomics, Center for Genome Medicine, King Faisal Specialist Hospital and Research Centre (KFSHRC), Riyadh, Saudi Arabia
- Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Chemistry, Memorial University of Newfoundland, St. John’s, NL, Canada
- *Correspondence: Assim A. Alfadda, ; Anas M. Abdel Rahman,
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Jiang X, Zhao X, Gu X, Luo T, Li P, Wan C, Liu H. Serum metabolomic analysis in patients with Hashimoto's thyroiditis. Front Endocrinol (Lausanne) 2022; 13:1046159. [PMID: 36619550 PMCID: PMC9814722 DOI: 10.3389/fendo.2022.1046159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Hashimoto's thyroiditis, an autoimmune thyroid disease, shows high morbidity worldwide, particularly in female. Patients with Hashimoto's thyroiditis have an increasing risk of hypothyroidism during the occurrence and progression of Hashimoto's thyroiditis. In recent years, metabolomics has been widely applied in autoimmune diseases, especially thyroid disorders. However, metabolites analysis in Hashimoto's thyroiditis is still absent. METHODS A total of 92 samples were collected, including 35 cases in the control group, 30 cases in the Hashimoto's thyroiditis with euthyroidism group, and 27 cases in the Hashimoto's thyroiditis with subclinical hypothyroidism group. SPSS 25.0 for statistical analysis and ROC curve, SIMCA 14.0, Metaboanalysis for multifactor analysis, and Origin 2021 for correlation analysis. RESULTS 21 metabolites were identified. 10 metabolites were obtained from control group versus HTE group, 8 serum metabolites were abnormal between control group and HTS group, 3 metabolites were derived from HTE group versus HTS. Kyoto Encyclopedia of Genes and Genomes Enrichment analysis showed that fatty acid degradation, Arginine, and proline metabolism have a significant impact on HTE, while lysine degradation, tyrosine metabolism play an important role HTS group, compared to control group. In the comparison between the HTE and HTS group, Valine, leucine, and isoleucine degradation and Valine, leucine, and isoleucine biosynthesis exists a key role. Correlation analysis shows clinical are not related to metabolites. ROC curve indicates SM, LPC, PC can efficiency in identification patients with HT in different clinical stage from healthy individuals. CONCLUSION Serum metabolites were changed in HT. Phospholipids such as SM, LPC, PC influence the pathogenesis of Hashimoto's thyroiditis. Fatty acid degradation and lysine degradation pathways have an impact on different clinical stage of HT.
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Affiliation(s)
- Xiao Jiang
- Endocrinology and Metabolism Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xinyu Zhao
- Endocrinology and Metabolism Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaotong Gu
- Endocrinology and Metabolism Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tao Luo
- Endocrinology and Metabolism Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Pengqian Li
- Endocrinology and Metabolism Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chuchu Wan
- Graduate School Department, Dalian Medical University, Dalian, China
| | - Haixia Liu
- Endocrinology and Metabolism Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Haixia Liu,
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Xia Q, Qian W, Chen L, Chen X, Xie R, Zhang D, Wu H, Sun H, Wang F, Liu J, Chen T. Comprehensive Metabolomics Study in Children With Graves' Disease. Front Endocrinol (Lausanne) 2021; 12:752496. [PMID: 34867796 PMCID: PMC8635134 DOI: 10.3389/fendo.2021.752496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/28/2021] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Graves' disease (GD) related hyperthyroidism (HT) has profound effects on metabolic activity and metabolism of macromolecules affecting energy homeostasis. In this study, we aimed to get a comprehensive understanding of the metabolic changes and their clinical relevance in GD children. METHODS We investigated serum substances from 30 newly diagnosed GD children and 30 age- and gender-matched healthy controls. We explored the metabolomics using ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS) analysis, and then analyzed the metabolomic data via multivariate statistical analysis. RESULTS By untargeted metabolomic analysis, a total of 730 metabolites were identified in all participants, among which 48 differential metabolites between GD and control groups were filtered out, including amino acids, dipeptides, lipids, purines, etc. Among these metabolites, 33 were detected with higher levels, while 15 with lower levels in GD group compared to controls. Pathway analysis showed that HT had a significant impact on aminoacyl-transfer ribonucleic acid (tRNA) biosynthesis, several amino acids metabolism, purine metabolism, and pyrimidine metabolism. CONCLUSION In this study, via untargeted metabolomics analysis, significant variations of serum metabolomic patterns were detected in GD children.
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Affiliation(s)
- Qin Xia
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Weifeng Qian
- Department of Thyroid and Breast Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Linqi Chen
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Xiuli Chen
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Rongrong Xie
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Dandan Zhang
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Haiying Wu
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Hui Sun
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Fengyun Wang
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
| | - Jingjing Liu
- Department of Biochemistry and Molecular Biology, School of Medical and Biological Sciences, Soochow University, Suzhou, China
| | - Ting Chen
- Department of Endocrinology, Genetics and Metabolism, Children’s Hospital of Soochow University, Suzhou, China
- *Correspondence: Ting Chen,
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Sarandi E, Thanasoula M, Anamaterou C, Papakonstantinou E, Geraci F, Papamichael MM, Itsiopoulos C, Tsoukalas D. Metabolic profiling of organic and fatty acids in chronic and autoimmune diseases. Adv Clin Chem 2020; 101:169-229. [PMID: 33706889 DOI: 10.1016/bs.acc.2020.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Metabolomics is a powerful tool of omics that permits the simultaneous identification of metabolic perturbations in several autoimmune and chronic diseases. Several parameters can affect a metabolic profile, from the population characteristics to the selection of the analytical method. In the current chapter, we summarize the main analytical methods and results of the metabolic profiling of fatty and organic acids performed in human metabolomic studies for asthma, COPD, psoriasis and Hashimoto's thyroiditis. We discuss the most significant metabolic alterations associated with these diseases, after comparison of either a single patient's group with healthy controls or several patient's subgroups of different disease severity and phenotype with healthy controls or of a patient's group before and after treatment. Finally, we present critical metabolic patterns that are associated with each disease and their potency for the unraveling of disease pathogenesis, prediction, diagnosis, patient stratification and treatment selection.
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Affiliation(s)
- Evangelia Sarandi
- Metabolomic Medicine Clinic, Athens, Greece; Laboratory of Toxicology and Forensic Sciences, Medical School, University of Crete, Heraklion, Greece
| | - Maria Thanasoula
- Metabolomic Medicine Clinic, Athens, Greece; European Institute of Nutritional Medicine, E.I.Nu.M, Rome, Italy
| | | | | | - Francesco Geraci
- European Institute of Nutritional Medicine, E.I.Nu.M, Rome, Italy
| | - Maria Michelle Papamichael
- Department of Rehabilitation, Nutrition & Sport, La Trobe University, School of Allied Health, Melbourne, VIC, Australia
| | - Catherine Itsiopoulos
- Department of Rehabilitation, Nutrition & Sport, La Trobe University, School of Allied Health, Melbourne, VIC, Australia
| | - Dimitris Tsoukalas
- Metabolomic Medicine Clinic, Athens, Greece; European Institute of Nutritional Medicine, E.I.Nu.M, Rome, Italy.
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Friedrich N, Pietzner M, Engelmann B, Homuth G, Führer D, Brabant G, Wallaschofski H, Völker U. Screening for New Markers to Assess Thyroid Hormone Action by OMICs
Analysis of Human Samples. Exp Clin Endocrinol Diabetes 2020; 128:479-487. [DOI: 10.1055/a-1144-2636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
ABSTRACTDetermination of the levels of thyroid-stimulating hormone (TSH) and free
thyroid hormones (fTHs) is crucial for assessing thyroid function. However,
as a result of inter-individual genetic variability and different
environmental factors individual set points exist for TSH and fTHs and
display considerable variation. Furthermore, under specific
pathophysiological conditions like central hypothyroidism, TSH secreting
pituitary tumors, or thyroid hormone resistance the established markers TSH
and fTH fail to reliably predict thyroid function and adequate supply of TH
to peripheral organs. Even in case of overt hyper- and hypothyroidism
circulating fTH concentrations do not correlate with clinical symptoms.
Therefore, there is a clear need for novel, more specific biomarkers to
diagnose and monitor thyroid function. OMICs screening approaches allow
parallel profiling of hundreds to thousands of molecules and thus
comprehensive monitoring of molecular alterations in tissues and body fluids
that might be associated with changes in thyroid function. These techniques
thus constitute promising tools for the identification of urgently needed
novel biomarkers. This mini review summarizes the findings of OMICs studies
in thyroid research with a particular focus on population-based and patient
studies as well as interventional approaches investigating the effects of
thyroid hormone administration.
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Affiliation(s)
- Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University
Medicine Greifswald, Greifswald, Germany
| | - Maik Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University
Medicine Greifswald, Greifswald, Germany
| | - Beatrice Engelmann
- Interfaculty Institute for Genetics and Functional Genomics, University
Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University
Medicine Greifswald, Greifswald, Germany
| | - Dagmar Führer
- Departments of Endocrinology, Diabetes and Metabolism, University
Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Georg Brabant
- Internal Medicine I, University of Lübeck, Lübeck,
Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University
Medicine Greifswald, Greifswald, Germany
- Praxis für Endokrinologie, Erfurt, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University
Medicine Greifswald, Greifswald, Germany
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Wang Y, Li X, Yang Q, Wang W, Zhang Y, Liu J, Zheng L, Zha B. Granulocyte-Colony-Stimulating Factor Effectively Shortens Recovery Duration in Anti-Thyroid-Drug-Induced Agranulocytosis: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2019; 10:789. [PMID: 31824417 PMCID: PMC6882865 DOI: 10.3389/fendo.2019.00789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 10/30/2019] [Indexed: 11/16/2022] Open
Abstract
Background and aim: Granulocyte-colony-stimulating factor (G-CSF) is highly beneficial as a general treatment for anti-thyroid drug (ATD)-induced agranulocytosis. This meta-analysis aimed to assess the clinical effects of G-CSF and non-G-CSF on recovery duration in patients with ATD-induced agranulocytosis by analyzing the overall clinical outcomes. Methods: The PubMed, Embase, Ovid, Cochrane, Google Scholar, China National Knowledge Infrastructure (CNKI) databases were searched for published studies from 1900 to 2018. No language restriction was implemented. Results: This meta-analysis included 10 published retrospective studies and one prospective study. Data were obtained from 11 trials (474 patients: 247 with G-CSF and 227 with non-G-CSF treatment). Compared with the non-G-CSF group, the G-CSF group presented shorter recovery duration [weighted mean difference (WMD) = -3.04 days, 95% confidence interval (95% CI): -4.38 to -1.69 (Z = 4.43 P = 0.000)]. However, the recovery duration varied across regions and recovery criteria. Asian patients achieved significant clinical outcomes [WMD = -3.16 days (95% CI: -4.58 to -1.74, P = 0.000)] compared with European and South American patients [WMD = -2.19 days (95% CI: -7.38 to 3.01, P = 0.409)]. Also, according to various recovery criteria, a duration of granulocyte count increase of more than 1.5 or 1.0 × 109/L [WMD = -3.50 days (95% CI: -4.82 to -2.18, P = 0.000)] revealed a better treatment effect. Conclusion: G-CSF can significantly shorten the recovery duration in patients with ATD-induced agranulocytosis.
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Affiliation(s)
- Yonghui Wang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
- Department of Geriatrics, Xinhua Hospital of Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xiaoying Li
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Qian Yang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Wei Wang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Yanan Zhang
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Jun Liu
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
| | - Liang Zheng
- Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Liang Zheng
| | - Bingbing Zha
- Department of Endocrinology, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China
- Bingbing Zha
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Al Majdoub M, Lantz M, Spégel P. Alterations in levels of intermediate-chained acylcarnitines associate with weight-gain following reestablishment of euthyroidism in Graves' disease. Endocrine 2019; 63:164-166. [PMID: 30178436 DOI: 10.1007/s12020-018-1735-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/23/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Mahmoud Al Majdoub
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Mikael Lantz
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Peter Spégel
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
- Department of Chemistry, Centre for Analysis and Synthesis, Lund University, Lund, Sweden.
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13
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Pietzner M, Kacprowski T, Friedrich N. Empowering thyroid hormone research in human subjects using OMICs technologies. J Endocrinol 2018; 238:R13-R29. [PMID: 29724864 DOI: 10.1530/joe-18-0117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 05/03/2018] [Indexed: 12/16/2022]
Abstract
OMICs subsume different physiological layers including the genome, transcriptome, proteome and metabolome. Recent advances in analytical techniques allow for the exhaustive determination of biomolecules in all OMICs levels from less invasive human specimens such as blood and urine. Investigating OMICs in deeply characterized population-based or experimental studies has led to seminal improvement of our understanding of genetic determinants of thyroid function, identified putative thyroid hormone target genes and thyroid hormone-induced shifts in the plasma protein and metabolite content. Consequently, plasma biomolecules have been suggested as surrogates of tissue-specific action of thyroid hormones. This review provides a brief introduction to OMICs in thyroid research with a particular focus on metabolomics studies in humans elucidating the important role of thyroid hormones for whole body metabolism in adults.
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Affiliation(s)
- Maik Pietzner
- Institute of Clinical Chemistry and Laboratory MedicineUniversity Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research)Partner Site Greifswald, Greifswald, Germany
| | - Tim Kacprowski
- Chair of Experimental BioinformaticsTUM School of Life Sciences Weihenstephan Technical University of Munich, Freising-Weihenstephan, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory MedicineUniversity Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research)Partner Site Greifswald, Greifswald, Germany
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14
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Struja T, Eckart A, Kutz A, Huber A, Neyer P, Kraenzlin M, Mueller B, Meier C, Bernasconi L, Schuetz P. Metabolomics for Prediction of Relapse in Graves' Disease: Observational Pilot Study. Front Endocrinol (Lausanne) 2018; 9:623. [PMID: 30386302 PMCID: PMC6199355 DOI: 10.3389/fendo.2018.00623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022] Open
Abstract
Background: There is a lack of biochemical markers for early prediction of relapse in patients with Graves' disease [GD], which may help to direct treatment decisions. We assessed the prognostic ability of a high-throughput proton NMR metabolomic profile to predict relapse in a well characterized cohort of GD patients. Methods: Observational study investigating patients presenting with GD at a Swiss hospital endocrine referral center and an associated endocrine outpatient clinic. We measured 227 metabolic markers in the blood of patients before treatment initiation. Main outcome was relapse of hyperthyroidism within 18 months of stopping anti-thyroid drugs. We used ROC analysis with AUC to assess discrimination. Results: Of 69 included patients 18 (26%) patients had a relapse of disease. The clinical GREAT score had an AUC of 0.68 (95% CI 0.63-0.70) to predict relapse. When looking at the metabolomic markers, univariate analysis revealed pyruvate and triglycerides in medium VLDL as predictors with AUCs of 0.73 (95% CI 0.58-0.84) and 0.67 (95% CI 0.53-0.80), respectively. All other metabolomic markers had lower AUCs. Conclusion: Overall, metabolomic markers in our pilot study had low to moderate prognostic potential for prediction of relapse of GD, with pyruvate and triglycerides being candidates with acceptable discriminatory abilities. Our data need validation in future larger trials.
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Affiliation(s)
- Tristan Struja
- Division of Endocrinology, Diabetes and Metabolism, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- *Correspondence: Tristan Struja
| | - Andreas Eckart
- Division of Endocrinology, Diabetes and Metabolism, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
| | - Alexander Kutz
- Division of Endocrinology, Diabetes and Metabolism, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
| | - Andreas Huber
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Peter Neyer
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | | | - Beat Mueller
- Division of Endocrinology, Diabetes and Metabolism, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Christian Meier
- Endonet, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Luca Bernasconi
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Philipp Schuetz
- Division of Endocrinology, Diabetes and Metabolism, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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