In parallel with problems including nutrition transition, populations aging and obesity, chronic kidney disease (CKD) and hyperuricemia have brought public health challenges with the prevalence of both over 10% among Chinese adults.

CKD and hyperuricemia can lead to kidney failure or gout. Thus it is critical to have early diagnosis and prevention by identifying their risk factors and early biomarkers. However, few studies have investigated the links between metabolomic biomarkers to kidney function decline or hyperuricemia in prospective cohort settings.

Recently, in the studies published in Clinical Journal of the American Society of Nephrology and Arthritis Care & Research respectively, Prof. LIN Xu’s group from Shanghai Institute of Nutrition and Health of the Chinese Academy of Sciences (CAS) and Prof. ZENG Rong’s group from CAS Key Laboratory of Systems Biology revealed the associations of metabolomics profile with kidney function decline and hyperuricemia risk in Chinese population.

The researchers applied a gas or liquid chromatography coupled with mass spectrometry to detect 22 amino acids and 34 free carnitines/acylcarnitines in the cohort sample of the Nutrition and Health of Aging Population in China.

Besides, they analyzed the prospective associations of plasma metabolomic biomarkers with 6-year incident kidney function decline and hyperuricemia among participants who completed both baseline and a 6-year follow-up survey.

Among 1,765 participants free of kidney function decline at baseline, increased plasma cysteine, long-chain acylcarnitines and other acylcarnitines were significantly associated with higher incident kidney function decline defined as estimated glomerular filtration rate < 60 ml/min/1.73 m², independently of conventional risk factors including eGFR at baseline. Among 1, 621 participants free of hyperuricemia at baseline, increased plasma cysteine, glutamine, threonine and long-chain acylcarnitines were significantly associated with higher incident hyperuricemia defined as uric acid >420μmol/L in men and >360 μmol/L in women, independently of conventional risk factors including uric acid at baseline.

Related results were further verified by multivariate analyses (principal component analysis or network analysis).

In reduced rank regression, these metabolites were shown to be partially driven by intakes of the hyperuricemia associated foods like red and processed meat, and soy products, suggesting underlying mechanistic link of diet-metabolite-disease.

These two studies provide clues to early biomarkers, dietary factors and underlying mechanisms of kidney function decline and hyperuricemia, laying a foundation for their early diagnosis and prevention.