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Urinary VOCs may serve as measure of NAFLD progression

Urinary volatile organic compounds could potentially be used as an alternate, noninvasive test to measure the various stages of nonalcoholic fatty liver disease, according to recently published study data.

“This pilot study provides initial evidence that urinary [volatile organic compounds (VOC)] have potential application as an alternative noninvasive diagnostic test to distinguish between the various stages of NAFLD compared with healthy control subjects,” the researchers wrote. “This was achieved through the detection of unique gas phase bio-odorant fingerprints found in urine. Moreover it expands on previous research on VOC patterns in urine of patients with luminal gastrointestinal disease.”

Researchers analyzed urine samples of 34 participants (mean age, 62 years), including eight with nonalcoholic steatohepatitis and cirrhosis, seven with NASH without cirrhosis, four with NAFLD and 15 healthy controls. Urine was collected, frozen and then defrosted and placed into vials that were heated for analysis.

Analyses showed that urinary VOCs were capable of differentiating the samples of patients with liver disease from the healthy controls with a sensitivity of 0.58 (0.33-0.88). Specificity was 0.93 (0.698-1), however, and the area under the receiver operating curve (AUROC) was 0.73 (0.55- 0.9).

The compounds also were able to discern NASH patients, with and without cirrhosis, from those with NAFLD with a sensitivity of 0.73 (0.45-0.92), specificity of 0.79 (0.54-0.94) and AUROC of 0.79 (0.64-0.95).

The urinary VOCs smell prints also distinguished NAFLD patients from controls and NASH patients with cirrhosis from patients with NASH alone.

“[This study] provides some evidence that the detection of these urinary VOCs could represent a way forward in the search to find an alternative approach to the diagnosis and monitoring of patients with confirmed fatty liver disease, especially in cases where patients are unwilling to undergo liver biopsy or those in whom liver biopsy is deemed unsuitable,” the researchers concluded. “Further larger scale studies would need to be undertaken to confirm that the patterns shown here are also present in larger cohorts and to identify the chemicals involved.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.