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Open AccessArticle

Urinary Metabolomics in Pediatric Obesity and NAFLD Identifies Metabolic Pathways/Metabolites Related to Dietary Habits and Gut-Liver Axis Perturbations

Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatric Section, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
Theoreo srl, Via degli Ulivi 3, 84090 Montecorvino Pugliano (SA), Italy
Department of Pharmacy, University of Salerno, Via G. Paolo II, 84084 Fisciano (SA), Italy
European Laboratory of Food Induced Disease (ELFID), 80100 Naples, Italy
Author to whom correspondence should be addressed.
The authors contributed equally to the manuscript.
Nutrients 2017, 9(5), 485;
Received: 2 April 2017 / Revised: 28 April 2017 / Accepted: 6 May 2017 / Published: 11 May 2017
(This article belongs to the Special Issue Nutrition and Non-alcoholic Fatty Liver Disease)
To get insight into still elusive pathomechanisms of pediatric obesity and non-alcoholic fatty liver disease (NAFLD) we explored the interplay among GC-MS studied urinary metabolomic signature, gut liver axis (GLA) abnormalities, and food preferences (Kid-Med). Intestinal permeability (IP), small intestinal bacterial overgrowth (SIBO), and homeostatic model assessment-insulin resistance were investigated in forty children (mean age 9.8 years) categorized as normal weight (NW) or obese (body mass index <85th or >95th percentile, respectively) ± ultrasonographic bright liver and hypertransaminasemia (NAFLD). SIBO was increased in all obese children (p = 0.0022), IP preferentially in those with NAFLD (p = 0.0002). The partial least-square discriminant analysis of urinary metabolome correctly allocated children based on their obesity, NAFLD, visceral fat, pathological IP and SIBO. Compared to NW, obese children had (1) higher levels of glucose/1-methylhistidine, the latter more markedly in NAFLD patients; and (2) lower levels of xylitol, phenyl acetic acid and hydroquinone, the latter especially in children without NAFLD. The metabolic pathways of BCAA and/or their metabolites correlated with excess of visceral fat centimeters (leucine/oxo-valerate), and more deranged IP and SIBO (valine metabolites). Urinary metabolome analysis contributes to define a metabolic fingerprint of pediatric obesity and related NAFLD, by identifying metabolic pathways/metabolites reflecting typical obesity dietary habits and GLA perturbations. View Full-Text
Keywords: obesity; fatty liver; children; metabolome; urine obesity; fatty liver; children; metabolome; urine
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Troisi, J.; Pierri, L.; Landolfi, A.; Marciano, F.; Bisogno, A.; Belmonte, F.; Palladino, C.; Guercio Nuzio, S.; Campiglia, P.; Vajro, P. Urinary Metabolomics in Pediatric Obesity and NAFLD Identifies Metabolic Pathways/Metabolites Related to Dietary Habits and Gut-Liver Axis Perturbations. Nutrients 2017, 9, 485.

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