Preliminary determination of the association between symptom expression and urinary metabolites in subjects with chronic fatigue syndrome.

Abstract

Chronic fatigue syndrome (CFS) patients have a urinary metabolite labeled CFSUM1 with increased incidence (P < 0.004) and relative abundance (P < 0.00003). The relative abundances of urinary CFSUM1 and beta-alanine were associated with alterations in metabolite excretion and symptom incidence. In 20 CFS patients and 45 non-CFS subjects, symptom/metabolite associations were investigated by assessing symptom sensitivity and specificity, and symptom indices of total symptom incidence, CFS core symptoms, cognitive, neurological, musculoskeletal, gastrointestinal, infection-related and genitourinary symptom indices, as well as a visual analogue pain scale of average pain intensity. Thirty-three symptoms had significant (P < 0.005) sensitivity and specificity in the CFS patients compared to that in the non-CFS controls. Severe fatigue was the only symptom with 100% sensitivity and specificity and CFSUM1 excretion was the primary metabolite for expression of this symptom. All nine symptom indices had elevated responses in the CFS patients (all P < 0.0000001). Multiple regression analyses indicated that all the symptom indices had significant correlations (R) with changes in the urinary excretion of metabolites (P < 0.0001). CFSUM1 and beta-alanine were the first and second metabolites correlated with the CFS core symptom index and CFSUM1 was primarily associated with infection-related and musculoskeletal indices whereas beta-alanine was primarily associated with gastrointestinal and genitourinary indices. The strong associations of CFSUM1 and beta-alanine with CFS symptom expression provide a molecular basis for developing an objective test for CFS.

• Authors: N R McGregor, R H Dunstan, M Zerbes, H L Butt, T K Roberts, I J Klineberg
• Journal: Biochemical and molecular medicine (Biochem Mol Med) Vol. 58 Issue 1 Pg. 85-92 (Jun 1996) ISSN: 1077-3150 [Print] United States
• PMID: 8809350 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• 3-amino-1-methylpyrrolidin-2-ol
• Pyrrolidines

Topics

• Adolescent
• Adult
• Fatigue Syndrome, Chronic (urine)
• Female
• Gas Chromatography-Mass Spectrometry
• Humans
• Male
• Middle Aged
• Pyrrolidines (urine)
• Regression Analysis
• Sensitivity and Specificity