Amino acid and acylcarnitine profiles in perinatal asphyxia: a case-control study

Abstract

Objective: To estimate cord blood amino acid and acylcarnitine levels in term newborns exposed to perinatal asphyxia.

Materials and methods: We studied 45 asphyxiated term newborns (cases) and 20 gestational age-matched healthy newborns (control). 16 cases developed HIE according to clinical scoring and amplitude-integrated electroencephalography. Asphyxiated cases were accordingly subdivided into: HIE group (n = 16) and Asphyxia group (n = 29). Amino acid and acylcarnitine levels were measured in cord blood dried spot samples from all newborns using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Data were analyzed using one-way ANOVA with post hoc test and MetaboAnalyst-2.

Results: Distinct metabolite alterations were detected in cases versus control, in HIE versus Asphyxia, and in Survivors within HIE group (n = 6) versus nonsurvivors (n = 10). Principal component analysis (PCA) and partial least squares-discriminate analysis (PLS-DA) showed increased levels of methionine and certain acylcarnitines, but reduced levels of ornithine, histidine, and arginine. Metabolite set enrichment analysis (MSEA); compared to KEGG library metabolite sets, identified some disorders with similar metabolomic derangements.

Conclusions: We report UPLC-MS detectable alterations of amino acids and acylcarnitines in asphyxiated newborns at birth, that can serve as early diagnostic bedside biomarkers for HIE and predictors for its short-term outcome, and in the near future, as therapeutic targets.

Keywords:

• Asphyxia
• HIE
• UPLC-MS
• amino acid
• acylcarnitine
• MetaboAnalyst-2

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.