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Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates.

Abstract

Background and Objective

Early identification of neonates at risk for brain injury is important to start appropriate intervention. Urinary metabolomics is a source of potential, noninvasive biomarkers of brain disease. We studied the urinary metabolic profile at 2 and 10 days in preterm neonates with normal/mild and moderate/severe MRI abnormalities at term equivalent age.

Methods

Urine samples were collected at two and 10 days after birth in 30 extremely preterm infants and analyzed using proton magnetic resonance spectroscopy. A 3 T MRI was performed at term equivalent age, and images were scored for white matter (WM), cortical grey matter (cGM), deep GM, and cerebellar abnormalities. Infants were divided in two groups: normal/mild and moderately/severely abnormal MRI scores.

Results

No significant clustering was seen between normal/mild and moderate/severe MRI scores for all regions at both time points. The ROC curves distinguished neonates at 2 and 10 days who later developed a markedly less mature cGM score from the others (2 d: area under the curve (AUC) = 0.72, specificity (SP) = 65%, sensitivity (SE) = 75% and 10 d: AUC = 0.80, SP = 78%, SE = 80%) and a moderately to severely abnormal WM score (2 d: AUC = 0.71, specificity (SP) = 80%, sensitivity (SE) = 72% and 10 d: AUC = 0.69, SP = 64%, SE = 89%).

Conclusions

Early urinary spectra of preterm infants were able to discriminate metabolic profiles in patients with moderately/severely abnormal cGM and WM scores at term equivalent age. Urine spectra are promising for early identification of neonates at risk of brain damage and allow understanding of the pathogenesis of altered brain development.

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  • Authors+Show Affiliations

    ,

    Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

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    Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.

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    Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.

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    Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.

    ,

    NMR Centre, University of Siena, Siena, Italy.

    ,

    NMR Centre, University of Siena, Siena, Italy.

    ,

    Kode srl, Pisa, Italy.

    ,

    Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

    ,

    Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

    ,

    Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.

    Department of Neonatology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

    Source

    Disease markers 2018: 2018 pg 4938194

    MeSH

    Biomarkers
    Brain
    Developmental Disabilities
    Female
    Humans
    Infant, Extremely Premature
    Infant, Newborn
    Magnetic Resonance Imaging
    Male
    Metabolome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30402168

    Citation

    Tataranno, Maria Luisa, et al. "Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates." Disease Markers, vol. 2018, 2018, p. 4938194.
    Tataranno ML, Perrone S, Longini M, et al. Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates. Dis Markers. 2018;2018:4938194.
    Tataranno, M. L., Perrone, S., Longini, M., Coviello, C., Tassini, M., Vivi, A., ... Benders, M. J. N. L. (2018). Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates. Disease Markers, 2018, p. 4938194. doi:10.1155/2018/4938194.
    Tataranno ML, et al. Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates. Dis Markers. 2018;2018:4938194. PubMed PMID: 30402168.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Predictive Role of Urinary Metabolic Profile for Abnormal MRI Score in Preterm Neonates. AU - Tataranno,Maria Luisa, AU - Perrone,Serafina, AU - Longini,Mariangela, AU - Coviello,Caterina, AU - Tassini,Maria, AU - Vivi,Antonio, AU - Calderisi,Marco, AU - deVries,Linda S, AU - Groenendaal,Floris, AU - Buonocore,Giuseppe, AU - Benders,Manon J N L, Y1 - 2018/10/01/ PY - 2018/07/05/received PY - 2018/08/26/accepted PY - 2018/11/8/entrez PY - 2018/11/8/pubmed PY - 2019/2/20/medline SP - 4938194 EP - 4938194 JF - Disease markers JO - Dis. Markers VL - 2018 N2 - Background and Objective: Early identification of neonates at risk for brain injury is important to start appropriate intervention. Urinary metabolomics is a source of potential, noninvasive biomarkers of brain disease. We studied the urinary metabolic profile at 2 and 10 days in preterm neonates with normal/mild and moderate/severe MRI abnormalities at term equivalent age. Methods: Urine samples were collected at two and 10 days after birth in 30 extremely preterm infants and analyzed using proton magnetic resonance spectroscopy. A 3 T MRI was performed at term equivalent age, and images were scored for white matter (WM), cortical grey matter (cGM), deep GM, and cerebellar abnormalities. Infants were divided in two groups: normal/mild and moderately/severely abnormal MRI scores. Results: No significant clustering was seen between normal/mild and moderate/severe MRI scores for all regions at both time points. The ROC curves distinguished neonates at 2 and 10 days who later developed a markedly less mature cGM score from the others (2 d: area under the curve (AUC) = 0.72, specificity (SP) = 65%, sensitivity (SE) = 75% and 10 d: AUC = 0.80, SP = 78%, SE = 80%) and a moderately to severely abnormal WM score (2 d: AUC = 0.71, specificity (SP) = 80%, sensitivity (SE) = 72% and 10 d: AUC = 0.69, SP = 64%, SE = 89%). Conclusions: Early urinary spectra of preterm infants were able to discriminate metabolic profiles in patients with moderately/severely abnormal cGM and WM scores at term equivalent age. Urine spectra are promising for early identification of neonates at risk of brain damage and allow understanding of the pathogenesis of altered brain development. SN - 1875-8630 UR - https://www.unboundmedicine.com/medline/citation/30402168/Predictive_Role_of_Urinary_Metabolic_Profile_for_Abnormal_MRI_Score_in_Preterm_Neonates L2 - https://dx.doi.org/10.1155/2018/4938194 DB - PRIME DP - Unbound Medicine ER -