Novel, objective, multivariate biomarkers composed of plasma amino acid profiles for the diagnosis and assessment of inflammatory bowel disease

Tadakazu Hisamatsu, Susumu Okamoto, Masaki Hashimoto, Takahiko Muramatsu, Ayatoshi Andou, Michihide Uo, Mina T. Kitazume, Katsuyoshi Matsuoka, Tomoharu Yajima, Nagamu Inoue, Takanori Kanai, Haruhiko Ogata, Yasushi Iwao, Minoru Yamakado, Ryosei Sakai, Nobukazu Ono, Toshihiko Ando, Manabu Suzuki, Toshifumi Hibi

Research output: Contribution to journalArticlepeer-review

149 Citations (Scopus)


Background: Inflammatory bowel disease (IBD) is a chronic intestinal disorder that is associated with a limited number of clinical biomarkers. In order to facilitate the diagnosis of IBD and assess its disease activity, we investigated the potential of novel multivariate indexes using statistical modeling of plasma amino acid concentrations (aminogram). Methodology and Principal Findings: We measured fasting plasma aminograms in 387 IBD patients (Crohn's disease (CD), n = 165; ulcerative colitis (UC), n = 222) and 210 healthy controls. Based on Fisher linear classifiers, multivariate indexes were developed from the aminogram in discovery samples (CD, n = 102; UC, n = 102; age and sex-matched healthy controls, n = 102) and internally validated. The indexes were used to discriminate between CD or UC patients and healthy controls, as well as between patients with active disease and those in remission. We assessed index performances using the area under the curve of the receiver operating characteristic (ROC AUC). We observed significant alterations to the plasma aminogram, including histidine and tryptophan. The multivariate indexes established from plasma aminograms were able to distinguish CD or UC patients from healthy controls with ROC AUCs of 0.940 (95% confidence interval (CI): 0.898-0.983) and 0.894 (95%CI: 0.853-0.935), respectively in validation samples (CD, n = 63; UC, n = 120; healthy controls, n = 108). In addition, other indexes appeared to be a measure of disease activity. These indexes distinguished active CD or UC patients from each remission patients with ROC AUCs of 0.894 (95%CI: 0.853-0.935) and 0.849 (95%CI: 0.770-0.928), and correlated with clinical disease activity indexes for CD (r s = 0.592, 95%CI: 0.385-0.742, p<0.001) or UC (r s = 0.598, 95%CI: 0.452-0.713, p<0.001), respectively. Conclusions and Significance: In this study, we demonstrated that established multivariate indexes composed of plasma amino acid profiles can serve as novel, non-invasive, objective biomarkers for the diagnosis and monitoring of IBD, providing us with new insights into the pathophysiology of the disease.

Original languageEnglish
Article numbere31131
JournalPloS one
Issue number1
Publication statusPublished - 2012 Jan 31

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology
  • General Agricultural and Biological Sciences
  • General


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