Nicotinuric Acid:A potential marker of metabolic syndrome through a metabolomics-based approach

Chun-Feng Huang, MD, Mei-Ling Cheng, PHD, Chun-Ming Fan, Chuang-Ye Hong, MD, PHD and Ming-Shi Shiao, PHD

Diabetes Care December 28, 2012  Published online before print December 28, 2012, doi: 10.2337/dc12-1067

Abstract

OBJECTIVE Metabolic syndrome is a multiplex disorder and puts patients on the road to type 2 diabetes and atherosclerotic cardiovascular diseases. However, a surrogate biomarker in plasma or urine in fully reflecting features of metabolic syndrome has not been explored.

RESEARCH DESIGN AND METHODS Urine metabolomics has potential utility in metabolic profiling because urine metabolites analysis reflects global outflux of metabolic change. Accordingly, we collected data on subjects (n = 99) with overweight, dyslipidemia, hypertension or impaired glucose tolerance and took a metabolomics approach to analyze the metabolites of urine revealed in metabolic syndrome by high-performance liquid chromatography–time-of-flight mass spectrometry and elicit potential biomarkers to picture metabolic syndrome.

RESULTS Our results revealed that the urine nicotinuric acid value of subjects with diabetes (HbA1c ≥6.5% or those receiving diabetes medications) (n = 25) was higher than subjects without diabetes (n = 37) (221 ± 31 vs. 152 ± 13 × 103 mAU, P = 0.0268). Moreover, urinary nicotinuric acid level was positively correlated with body mass index, blood pressure, total cholesterol, low-density lipoprotein cholesterol, triacylglycerol and high sensitivity C-reactive protein, but negatively correlated with high-density lipoprotein cholesterol.

CONCLUSIONS This is the first study, to our knowledge, to propose that nicotinuric acid represents an important pathogenic mechanism in process from metabolic syndrome to diabetes and atherosclerotic cardiovascular disease.