Poster Presentation 2014 International Biophysics Congress

NMR based metabonomics of blood plasma in celiac disease  (#552)

Deepti Upadhyay 1 , Uma Sharma 1 , Prasenjit Das 2 , Siddharth Datta Gupta 2 , Govind K. Makharia 3 , Naranamangalam R Jagannathan 1
  1. Department of NMR & MRI Facilty, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. Department of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  3. Department of Gastroenterology & Human Nutrition, All India Institute of Medical Sciences, New Delhi, Delhi, India

Celiac Disease (CeD) is an autoimmune enteropathy caused by ingestion of gluten and related prolamines in genetically predisposed individuals. The diagnosis of CeD is challenging due to multisystem clinical manifestations. The objective of the present study was to understand the metabolic changes that accompany CeD using NMR spectroscopy and to determine biochemical marker/s that would aid in the diagnosis of CeD. The blood plasma of CeD patients (n=29; mean 28.6±10.4 yrs) and healthy controls (HC; n=16; mean 28.8±6.4 yrs) were collected and were subjected to proton NMR spectroscopy at 700 MHz. Informed consent was taken from all subjects and study was approved by Institute Ethics Committee. The diagnosis of CeD was made following the criteria by European Society of Pediatric Gastroenterology Hepatology and Nutrition. Forty metabolites were identified using 1D and 2D NMR and concentrations of 23 metabolites were determined and compared using Student t-test between the groups. Partial least squares-discriminant analysis (PLS-DA) indicated distinct clustering of two groups. CeD patients showed significantly higher levels of glucose, acetoacetate, β-hydroxybutyrate and glycine. High glucose and acetoacetate indicate metabolic abnormalities in carbohydrate metabolism. Ketone bodies are used as energy source when glucose is not metabolized properly for energy generation. Oxidation of ketone bodies produces less energy as compared to glycolysis, which may explain chronic fatigue observed in CeD patients. Glycine is a gluconeogenic amino acid and its higher concentration indicates that it might not have been utilized for glucose production. Further utilization of ketone bodies has also been shown to inhibit the gluconeogenesis. Creatinine is produced from amino acids primarily in liver and kidney and transported to blood. Lower level of creatinine observed in CeD may indicate malabsorption of proteins. These findings provide an insight to understand the metabolic alterations in CeD and hence help to identify putative biomarker/s for CeD.