The first human normative ranges and biomarker performance of dimethylguanidino valeric acid isoforms in fatty liver disease

Copyright © 2023. Published by Elsevier B.V..

We have recently determined dimethylguanidino valeric acid (DMGV) to be a novel biomarker of liver injury in non-alcoholic fatty liver disease (NAFLD) and an independent predictor of incident diabetes over a decade in advance. DMGV consists of two stereo-isomers, asymmetric dimethylguanidino valeric acid (ADGV) and symmetric dimethylguanidino valeric acid (SDGV). Here we report, for the first time, the upper limits of normal of both isomers in humans at the accepted 5.56% liver fat threshold for NAFLD, determined using in vivo magnetic resonance spectroscopy. We performed independent and blinded comparative analyses of ADGV and SDGV levels using two different liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods in (A) our laboratory, and (B) the New South Wales Chemical Pathology state laboratory, using unique columns, LC-MS/MS equipment, extraction protocols and normalisation approaches. Despite these differences, each laboratory reported consistent absolute concentrations across a range of liver fat percentages. We next determined the diagnostic performance of SDGV compared to ADGV in a cohort of 268 individuals with liver fat measurements. In derivation-validation analyses we determined rule-in/rule-out thresholds and the concentration of SDGV that provides optimal performance across sensitivity and specificity for the identification of NAFLD. In conclusion, we have herein determined for the first time the true human plasma reference range of both isoforms of an emerging novel biomarker of NAFLD, at the accepted upper normal threshold of liver fat. We have also identified that SDGV is the isoform with the best diagnostic performance and determined the optimal cut-point for its detection of NAFLD.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:56

Enthalten in:

Pathology - 56(2024), 3 vom: 01. März, Seite 391-397

Sprache:

Englisch

Beteiligte Personen:

Qadri, Sami [VerfasserIn]
Wang, XiaoSuo [VerfasserIn]
Tran, Collin [VerfasserIn]
Fitzpatrick, Michael [VerfasserIn]
Bonnitcha, Paul [VerfasserIn]
Sullivan, David [VerfasserIn]
Yki-Järvinen, Hannele [VerfasserIn]
O'Sullivan, John F [VerfasserIn]

Links:

Volltext

Themen:

ADGV
Biomarkers
Diagnosis
GZK92PJM7B
Journal Article
Liquid chromatography
Liver fat
Magnetic resonance spectroscopy
Metabolic dysfunction-associated steatotic liver disease
N-pentanoic acid
Non-alcoholic fatty liver disease
Pentanoic Acids
Reference values
SDGV
Tandem mass spectrometry

Anmerkungen:

Date Completed 15.03.2024

Date Revised 15.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.pathol.2023.10.006

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365619701