Explorer H nuclear magnetic resonance spectroscopy - based metabonomic study in patients with cirrhosis and hepatic encephalopathy

AIM: To identify plasma metabolites used as biomarkers in order to distinguish cirrhotics from controls and encephalopathics. METHODS: A clinical study involving stable cirrhotic patients with and without overt hepatic encephalopathy was designed. A control group of healthy volunteers was used. Plasma from those patients was analysed using H nuclear magnetic resonance spectroscopy. We used the Carr Purcell Meiboom Gill sequence to process the sample spectra at ambient probe temperature. We used a gated secondary irradiation field for water signal suppression. Samples were calibrated and referenced using the sodium trimethyl silyl propionate peak at 0.00 ppm. For each sample 128 transients (FID’s) were acquired into 32 K complex data points over a spectral width of 6 KHz. 30 degree pulses were applied with an acquisition time of 4.0 s in order to achieve better resolution, followed by a recovery delay of 12 s, to allow for complete relaxation and recovery of the magnetisation. A metabolic profile was created for stable cirrhotic patients without signs of overt hepatic encephalopathy and encephalopathic patients as well as healthy controls. Stepwise discriminant analysis was then used and discriminant factors were created to differentiate between the three groups. Submit a Manuscript: http://www.wjgnet.com/esps/ Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx DOI: 10.4254/wjh.v7.i12.1701 1701 June 28, 2015|Volume 7|Issue 12| WJH|www.wjgnet.com World J Hepatol 2015 June 28; 7(12): 1701-1707 ISSN 1948-5182 (online) © 2015 Baishideng Publishing Group Inc. All rights reserved. H nuclear magnetic resonance spectroscopy-based metabonomic study in patients with cirrhosis and hepatic encephalopathy Randomized Clinical Trial ORIGINAL ARTICLE Konstantinos John Dabos, John Andrew Parkinson, Ian Howard Sadler, John Nicholas Plevris, Peter Clive