Urinary Metabolomic Profiling in Chronic Hepatitis B Viral Infection Using Gas Chromatography/Mass Spectrometry

BACKGROUND: Chronic hepatitis B (CHB) can lead to cirrhosis and hepatocellular carcinoma. The metabolomic profiling has been shown to be associated with pathogenic mechanisms in many medical conditions including CHB. The purpose of this study was to investigate the urine metabolomic profiles in CHB patients by gas chromatography/mass spectrometry (GC/MS). METHODS: Urine samples were collected from CHB patients (n = 20) and normal control subjects (n = 20). Metabolite profiles were assessed using GC/MS in conjunction with multivariate statistical analysis, in order to identify biomarker metabolites. Pathway analysis was performed by MetaboAnalyst 3.0 and KEGG database. RESULTS: Twelve out of 377 metabolites were shown to be significantly different between the CHB and normal control groups (p < 0.05). These include palmitic acid, stearic acid, oleic acid, benzoic acid, butanoic acid, cholesterol, glycine, 3-heptanone, 4-heptanone, hexanal, 1-tetradecanol and naphthalene. Multivariate statistical analysis constructed using these expressed metabolites showed CHB patients can be discriminated from healthy controls with high sensitivity (95%) and specificity (85%). All the metabolic perturbations in this disease are associated with pathways of fatty acid, amino acid, bile acid and gut microbial metabolism. CONCLUSION: CHB patients have a specific urinary metabolomic profile. The abnormalities of fatty acid, amino acid, bile acid, and gut microbial metabolism lead to the development of disease progression. GC/MS-based assay is a promising tool for the metabolomic study in CHB.