Clinical metabolomics and hematic ADMA predict the future onset of cardiorenal syndrome in young grown-up subjects who were born preterm

Objectives: To look for differences in the urinary metabolic profile and in the hematic asymmetric dimethylarginine (ADMA) levels between a group of young adults born preterm with an extremely low birthweight (<1000 g; ex-ELBW; n = 19) and a control group of subjects born at term with a weight appropriate for their gestational age (AGA; n = 13); and to look for a possible correlation between the urinary metabolic profile in ex-ELBWand their hematic levels of ADMA. Design and methods: Urine samples were analyzed by H-1 nuclear magnetic resonance spectroscopy, and then submitted to unsupervised and supervised multivariate analysis. Samples of blood were collected and ADMA concentration was assessed by high-performance liquid chromatography. Results: Using supervised PLS-DA (partial least squares discriminant analysis) model, the authors were able to discriminate between ex-ELBWand AGA. Statistically significant differences were detected in the ADMA levels between ex-ELBWand AGA (p < 0.02). Ex-ELBW metabolic profile correlated with ADMA concentrations (r = 0.456, p < 0.05). Conversely, ADMA levels in AGA did not correlated with their metabolic profiles. Conclusions: This study demonstrates the relevance of the metabolomic technique as a predictive tool of the metabolic status in ex-ELBW. The relationship between ex-ELBW urinary metabolic profile and their blood ADMA levels suggests the presence of a subclinical cardio-renal involvement in these subjects.