AHMF: 98 Conference: Niblett

Haematology and Urinary Amino and Organic Acid Excretion in a Cohort of Patients with CFS

S.H. Niblett, L.A. Hoskin, R.H. Dunstan, P.Clifton-Bligh, N.McGregor, T.K. Roberts, H.L.Butt, G.R.Fulcher, K.King, J.Dunsmore, M.L.Nery.

Bioanalytical Research Group
Department of Biological Sciences
Newcastle University
Callaghan
NSW

Departments of Endocrinology and Health Promotion and Education
Royal North Shore Hospital
St Leonards
NSW.

One hundred subjects who had been diagnosed with Chronic Fatigue Syndrome (27 males: 73 females) mean age 29yrs (13 - 73yrs), and 86 healthy control subjects ( 24 males: 62 females) mean age 33yrs (14 -69 yrs), were recruited by physician referral, attendance at health information sessions, advertising and word of mouth for this study.

These subjects were reviewed by a physician, who took a full medical history, and performed a physical examination to confirm that the CFS subjects met the Oxford and CDC criteria for the diagnosis of Chronic Fatigue Syndrome, and that other diagnoses were excluded in both the CFS and control groups. All subjects were asked to refrain from taking "alternative medication" or vitamin supplements for one week prior to the date of sample collection.

On the day of assessment, subjects were asked to complete a series of questionnaires addressing demographics, medical history, duration and severity of the condition. A timed overnight urine sample was collected by each patient, and a 10ml aliquot sent to Newcastle University for analysis using the GCMS technique of 34 analytes. The excretion rate of each analyte was calculated. A full blood count was performed on all subjects

Significant differences were evident in the excretion rate of 12 urinary metabolites in CFS subjects compared to healthy controls. Tyrosine excretion was significantly elevated in CFS subjects(p=0.04), whereas the excretion rates for succinic acid (p=0.00001), asparagine (p=0.00001), UM17 (p=0.002), phenylalanine, (p=0.001) hippuric acid (p=0.01), proline, (p=0.004) alanine (p=0.01), s-methyl cysteine (p=0.01), leucine (p=0.03), phenylacetic acid (p=0.03) and valine (p=0.03) were significantly decreased in the CFS compared to the healthy controls.

The red blood cell distribution width (RDW) was significantly decreased, and the mean platelet volume (MPV) was significantly increased in the CFS subjects compared to the controls, although both were within the normal reference range. Canonical analysis of urine and blood parameters combined showed separation of CFS from Control subjects, with a predictive value of 80%. The possible significance of these findings will be discussed.