Part I: Recent Advances in Metabolomics Research

Gut: "Metabnomics" Distinguishes Between Pancreatic Cancer and Pancreatitis

A metabolic dynamic image called Metabolomics has been used to identify new blood metabolite biomarkers that distinguish between pancreatic cancer and chronic pancreatitis. It has a higher sensitivity than traditional diagnostic methods and is suitable for use in the earlier stages of the diseases.

"Among patients with chronic pancreatitis with an increased risk of pancreatic cancer, biomarkers detected 98% of resectable pancreatic cancer (55/78, IA to IIB) with an accuracy of 90.4%."

The researchers reported that they used biomarker features to distinguish between pancreatic cancer and chronic pancreatitis. Assuming the cumulative incidence is 1.95%, the area under the curve is 0.96, the sensitivity is 89.9%, and the specificity is 91.3%. This successfully verified the characteristics of the biomarkers.

"In one-third of patients, the clinical application of this biomarker feature will achieve better diagnosis and treatment function than CA19-9." They said.

Currently, the 5-year survival rate of pancreatic cancer is about 6%. Pancreatic cancer may be the third leading cause of cancer-related death by 2030 due to delays in diagnosis and lack of new treatments.

Metabolomics has begun to enter the field of tumor diagnosis and tumor biology. The researchers suggested that this study might be "the greatest metabolomics study on cancer to date".

Urine Metabolites are Used to Predict the Risk of Diabetes in Individuals

Recently, at the 99th Endocrine Society Conference held in Orlando, USA, researchers from Duke University School of Medicine said that they found a special metabolic marker in the urine of young black adolescents with diabetes and obesity. This new marker is expected to help researchers effectively predict the risk of developing type 2 diabetes in adolescents.

According to Pinar Gumus Balikcioglu, MD, said "After detailed metabolic analysis, we found that a major metabolite level called serotonin decreased significantly in obese type 2 diabetic adolescents compared to non-diabetic obese adolescents. At the same time, the level of various other metabolites in the diabetic adolescents increased compared to non-diabetic adolescents.

The researchers then researched small molecule metabolites ("chemical fingerprints") that left the blood and urine. In previous study on obese adolescents, researchers analyzed the level of hormones and metabolites in blood samples, and identified multiple factors associated with insulin resistance. In this study, the researchers analyzed the metabolic profiles of 33 urine-collected African-American adolescents aged 8-18 in a 24 hours. The result showed that 13 of them had type 2 diabetes, 20 had no diabetes, and all subjects were comparable in age, gender, and body mass index. Before the study, participants who took metformin were told to stop taking the drug, but those taking insulin could continue with insulin therapy.

Through metabolic analysis, the researchers found that the lower level of 5-hydroxy-indoleacetic acids (5-HIAA, a major metabolite of serotonin) in the body were directly related to the development of diabetes. Although serotonin is the best regulator of mood regulation, it still has many functions, including controlling the function and development of islet beta cells. Researcher Gumus Balikcioglu said that lower level of serotonin or its by-products could reduce insulin release and promote obese individuals from insulin resistance to type 2 diabetes.