Urinary organic acids as biomarkers in the assessment of pulmonary function in children with asthma

Nutr Res. 2019 Jan;61:31-40. doi: 10.1016/j.nutres.2018.10.004. Epub 2018 Oct 13.


Childhood asthma prevalence continues to rise despite advancements in prevention and medical management strategies. The purpose of this study was to investigate correlations between urinary organic acids and pulmonary diagnostic tests, asthma control in Greek asthmatic children. We hypothesized that urinary organic acids are positively associated with poor pulmonary function in children with asthma. Seventy-two children, 5 to 12 years old with asthma were recruited from a pediatric asthma clinic in Athens, Greece. Pulmonary function was assessed using spirometry and exhaled nitric oxide analysis. Asthma control was measured qualitatively using the Asthma Control Questionnaire. Targeted metabolomic analysis of 34 urinary organic acids in children was conducted by gas chromatography-mass spectrometry. A statistically significant difference between girls and boys was found for asthma control score (P = .02), lactic acid (P = .03), but not for any other organic acids (P > .05). Statistically significant correlations were found between lactic acid and Forced Expiratory Volume in 1 second (FEV1) (P = .02), Forced Vital Capacity (FVC) (P = .03); 4- hydroxyphenylacetic acid and FEV1 (P = .01), FVC (P = .01); 5-hydroxyindoleacetic acid and FEV1/FVC (P = .03), eNO (P = .05); glycolic acid with Peak Expiratory Flow (PEF) (P = .03); and malic acid with asthma control (P = .02). In conclusion, metabolomics was used to determine correlations between urinary organic acids and conventional pulmonary diagnostic tests in Greek asthmatic children. Metabolomics could be a promising approach for asthma research and in detection of novel biomarkers for asthma monitoring and therapeutic targets for childhood asthma. This study contributes towards a better understanding of the biochemical pathways involved in asthma.

Keywords: Asthma; Children; Gas-chromatography–mass spectroscopy; Metabolic profile; Metabolomics; Urinary organic acids.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acids / urine*
  • Asthma / diagnosis*
  • Asthma / physiopathology
  • Asthma / urine
  • Biomarkers / urine
  • Breath Tests*
  • Child
  • Child, Preschool
  • Female
  • Forced Expiratory Volume*
  • Glycolates / urine
  • Greece
  • Humans
  • Hydroxyindoleacetic Acid / urine
  • Lactic Acid / urine
  • Lung / physiopathology*
  • Malates / urine
  • Male
  • Metabolomics
  • Spirometry*
  • Vital Capacity*


  • Acids
  • Biomarkers
  • Glycolates
  • Malates
  • glycolic acid
  • Lactic Acid
  • Hydroxyindoleacetic Acid
  • malic acid