The metabolomics of necrotising enterocolitis in preterm babies: an exploratory study

Abstract

Objective: No single diagnostic investigation is currently available for necrotising enterocolitis (NEC). We implemented a novel, untargeted, exploratory study to determine whether metabolomics can reveal early biomarker(s) of NEC. The effect of gestational age on the metabolome was also investigated.

Methods: Two serum samples were obtained from 12 preterm babies (born <30 weeks gestation) and eight term controls: sample “A” at ≤1 week of age and sample “B” once fully fed. Samples were subjected to gas chromatography–mass spectrometry. Metabolomic data was analysed by principal component analysis (PCA), univariate and network analysis.

Results: Sixteen metabolite features significantly differed when B samples were compared between preterm babies who subsequently developed NEC and preterm/term controls (p value <0.05). Of these seven metabolites were linked to up-regulation of IL-1β. Significant differences in 54 metabolite features (p value <0.05) were observed between preterm and term metabolomes. Of these, 12 metabolite features were linked to one network involved in carbohydrate/lipid metabolism (p = 1 × 10⁻³⁰).

Conclusions: Metabolomic differences were observed in preterm babies at risk of NEC. However, sample sizes were insufficient to confidently identify a biomarker. Network modelling of preterm and term metabolomes suggest possible nutritional deficiency and altered pro-insulin action in preterm babies.

• Biomarker
• metabolomics
• necrotising enterocolitis
• preterm
• term

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

This research was funded by the St Mary’s Hospital NICU Endowment Fund and a bursary from the University of Manchester MRes Medical Sciences Programme.