Targeted NMR?based serum metabolic profiling of serine, glycine and methionine in acute?on?chronic liver failure patients: Possible insights into mitochondrial dysfunction

Background A recent study based on blood metabolomics analysis revealed inflammation-associated mitochondrial dysfunction as a potential mechanism underlying acute-on-chronic liver failure (ACLF) in cirrhotic patients. Serine, glycine, and methionine serve to maintain healthy immune system adequately sustain functionality hepatocytes for regulating redox homeostasis through the production of antioxidant glutathione (GSH). Based this, we hypothesized that circulatory levels serine, glycine will be altered ACLF patients due acute worsening hepatic function may provide novel insights into well. Methods The concentrations were estimated sera 40 49 normal controls (NC) subject using 1D 1H-CPMG NMR spectra recorded at 800 MHz spectrometer. resulting metabolite compared unpaired Student t-test p-value < 0.05 was considered criterion statistical significance. diagnostic correlations established receiver-operating-characteristic (ROC) curve Pearson-r method, respectively. Results Circulating serine significantly decreased (Ser = 23.06 ± 1.67 µM Gly 83.11±7.52 µM) NC subjects 55.61 2.28 156.9±7.16 with 0.0001, whereas those increased (22.60 2.49 (=14.63 0.85 0.0015. Further, ROC yielded satisfactory sensitivity specificity methionine-to-glycine ratio (MGR) area under (AUROC) values equal to: 0.95 [95%CI 0.91-0.99] Ser; 0.87 0.79-0.95] Gly; 0.90 0.83-0.97] MGR. Conclusion Compared subjects, characterized by hypermethioninemia aberrantly suggesting possible disturbed therefore depressed ACLF.