Metabolomics and the Molecular Phenotype of Obesity Burant Lab Mary Treutelaar Jinghua Xu Sydney Bridges Joe Dosch Cristina Lara-Castro Julian Munoz Erin Shellman Katie Overmyer Charles Evans Arun Das Jane Cao Angela Subauste Tanu Soni IWMC Amy Rothberg Mitali Kapila Chritine Fowler Andrew Miller Internal Medicine Sub Pennathur Jaimen Byun Chemistry Bob Kennedy Matt Lorenz Chunhai Ruan MCRU Theresa Han-Markey Bionutrition Support Metabolic Kitchen Washington University Sam Klein NCIBI/CCMB Alla Karnovsky Maureen Sartor H V Jagadish Terry Weymouth Tim Hull Glenn Tarcea Jing Gao Brian Athey Jim Cavalcoli Funding DK072380 DK077200 DK089503 University of Wisconsin Robert C. and Alan Attie Veronica Atkins Foundation Columbia University Sharon Wardlaw Endowment for the Judith Korner Biological Sciences 1 Clinical and Molecular Phenotyping Biological Data Transcriptomics Proteomics Metabolomics Predictive Model of the System 2 Systems Roles DNA The ultimate potential of a cell The current direction of a cell Material Proteins Metabolites The functional capabilities of a cell Information RNA The limiting currency of a cell 3 The ‘omic’s Genome Transcriptome Proteome Metabolome ~30,000 genes ~100,000 transcripts ~1,000,000 protein forms? ~2000 to 5,000 metabolites 4 What is a Metabolite? • Any organic molecule detectable in the body with a MW < ~2000 Da • Includes peptides, oligonucleotides, sugars, nucleosides, organic acids, ketones, aldehydes, amines, amino acids, lipids, steroids, alkaloids and drugs (xenobiotics) • Includes human & microbial products • Concentration > 1nM* 5 Mass Distribution of Compounds in the Human Metabolome 50 • Metabolome Number of cmpds per 20 daltons 45 – natively biosynthesized – monomeric 40 35 30 • Complex metabolites • Xenobiome 25 20 15 10 5 0 0 200 Mass 400 600 800 1000 1200 1400 1600 1800 6 Why Are Metabolites Relevant? • • • • • Generate metabolic “signatures” Monitor/measure metabolite flux Monitor enzyme/pathway kinetics Assess/identify phenotypes Monitor gene/environment interactions • Track effects from toxins/drugs/surgery • Monitor consequences from gene KOs • Identify functions of unknown genes Metabolites are the Canaries of the Genome 7 Why Are Metabolites Relevant? • Generate metabolic “signatures” for disease states or host responses • Obtain a more “holistic” view of metabolism (and treatment) • Accelerate assessment & diagnosis • More rapidly and accurately (and cheaply) assess/identify disease phenotypes • Monitor gene/environment interactions • Rapidly track effects from drugs/surgery 8 2 Routes to Metabolomics ppm 7 6 5 4 Quantitative Methods 3 2 1 Chemometric (Pattern) Methods 25 20 TMAO hippurate allantoin creatinine taurine hippurate urea creatinine 15 10 citrate 5 2-oxoglutarate water Condition 1 succinate fumarate PC2 0 -5 -10 Control Condition 2 -15 ppm 7 6 5 4 3 2 1 -20 -25 -30 -20 -10 PC1 0 10 9 The Technology of Metabolomics 15.0e6 chromatogram 12.5e6 10.0e6 7500e3 5000e3 2500e3 5 10 15 20 25 30 35 4000e3 45 50 55 60 65 2500e3 120 mass spectrum 3500e3 40 150 mass spectrum 2250e3 2000e3 3000e3 1750e3 135 2500e3 1500e3 91 2000e3 1250e3 1000e3 1500e3 77 750e 3 107 1000e3 65 500e 3 51 500e 3 51 250e 3 77 105 136 0e3 0 25 50 75 100 125 144 63 89 117 0e3 150 0 25 50 75 100 166 125 150 175 175 10 Separations Based Metabolomics Platforms AD CE-MS GC-MS LC-MS Small Injection Volumes High resolution Soft ionization Library ID Full metabolome coverage Chemical derivitization Limited structural info High Resolution DA Low capacity Difficult MS interface Harsh ionization Requires charged analytes Lower Resolution Limited metabolite applicability • ALL ESI-MS Methods Are Subject to Ion Suppression • Response Factors of Analytes are Not Equal Adapted From: Want, E. J.; Cravatt, B. F.; Siuzdak, G., ChemBioChem 2005, 6, 1941 – 1951 Adapted From: Villas-Boas, S. G.; Mas, S.; Akesson, M.; Smedsgaard, J.; Nielsen, J., Mass Spectrom Rev 2005, 24, (5), 613-46 11 Relative risk of health problems associated with obesity Greatly increased (relative risk >>3) Moderately increased (relative risk 2-3) Diabetes Coronary heart disease Gall bladder disease Osteoarthritis (knees) Hypertension Hyperuricemia and gout Dyslipidemia Insulin resistance Slightly increased (relative risk 1-2) Cancer (breast cancer in postmenopausal women, endometrial cancer, colon cancer) Reproductive hormone abnormalities Breathlessness Polycystic ovary syndrome Sleep apnea Impaired fertility Low back pain Increased anesthetic risk Fetal defects arising from maternal obesity 12 Excess U.S. Medical Costs Related to Abnormal Body Weight Int J Obesity 2005;29:334-339 13 Causes of Obesity Genetics Behavior Environment 14 Environmental effects… Keith SW, et al. Int J Obes. 2006;30:1585-1594. 15 DBP: Metabolomics and Obesity Investigational Weight Management Clinic Nutrition Obesity Research Center Demonstration Unit • Primary goal: Develop tools for multiscalar integration of clinical, behavioral and molecular phenotyping data in a clinical setting. • Insurance-supported clinical care for 400 obese patient • Undertaking a variety of studies related to nutrition and obesity • Michigan Nutrition Obesity Center Demonstration Unit project: Broad phenotyping at baseline, 3 months, 24 months for 400 obese and baseline studies in100 lean (BMI < 27). 16 Phenotypic response to diets 350 Lipid Level (mg/dl) 300 250 200 150 100 50 0 Day 0 Day Day 21 21 PUFA CHO Total Cholesterol Day 0 Day Day 21 21 PUFA CHO Triglycerides Day 0 Day Day 21 21 PUFA CHO HDL Day 0 Day Day 21 21 PUFA CHO LDL 17 Lipomic assessment of plasma Principal Component Can macronutrient consumption be detected in fatty acid profiles? Analysis (% of total lipid in fraction) • 18:2 and 14:0 predicts PUFA at day 2, 7, 21 • 14:1 and 16:1 in TG and PL predicts day 2, 7, 21 CHO • 18:2 and 16:1 in CE predict day 21 CHO 18 Palmitoleate, Glucose and Insulin Sensitivity Correlation between glucose and 16:1 levels in CE 8 7 16:1 (%) Baseline R² = 0.7241 6 Day 21 Pufa R² = 0.0142 5 Day 21 CHO R² = 0.4835 4 Palmitoleate 3 2 1 0 70 90 100 Glucose 110 120 Correlations between HOMA and 16:1 levels in CE 8 16:1 (%) 80 7 R² = 0.2855 6 R² = 0.0426 5 R² = 0.2295 Baseline Day 21 Pufa Day 21 CHO 4 3 2 1 0 0 0.5 1 1.5 2 2.5 HOMA 19 Phenotyping of Patients Phenotyping: Investigational Weight Management Clinic (Rothberg) and Analysis Laboratory for Physical Activity and Exercise Intervention Research (Gordon) MMOC Human Phenotyping Core (Horowitz) MMOC Molecular Phenotyping Core (Burant) NCIBI/CCMB (Athey, Cavalcoli) • • • • • • • Anthropometric tests. Height, weight, blood pressure, heart rate, temperature, skin fold thickness, waist-to-hip ratio, skin fold thickness. Dual Energy X-Ray Absorptiometery (DEXA, new). Metabolic Assessment. VO2peak, resting metabolic rate (RMR) and R/Q measurement. Oral glucose tolerance tests (for those without a diagnosis of diabetes), Total cholesterol, LDL, HDL, triglycerides, free fatty acid, insulin (at 0 and 30 and 120 minutes of oGTT), leptin, adiponectin, C-Reactive Protein. Peripheral Blood Metabolomic Assessment (including lipomics). The pattern of metabolite levels will be determined, including fatty acid profiles of lipid subclasses in EDTA collected plasma Peripheral Blood Transcriptomic Assessment. Fasting blood collected for RNA expression will be collected in PaxGene tube Genomic Assessment. DNA will be isolated from peripheral blood for assessment of DNA polymorphisms related to obesity and ability to lose weight (Boehnke, not funded). Muscle and adipose tissue biopsy metabolite and transcript analysis. Biopsies will be performed on the vastus lateralis muscle and anterior abdominal fat. Behavioral assessment. 4-Day Food Intake Record. A Depression inventory ( Beck Depression (BDII) 21 item questionnaire or Zung Self-Rating Questionnaire). 20 Gastric Bypass and Gastric Banding Pre-operative Medications Post-operative Medications 21 Weight Maintenance after Bariatric Surgery N Engl J Med. 2004;351:26 22 Gastric Bypass and Gastric Banding Early Clinical Effects Int J Obes (Lond). 34:462-471, 2010 23 Differentiating Roux-en-Y and Gastric Banding-30 min of MMTT Administer 250 cc Ensure 0 15 30 60 90 120 150 180 + 650 mg acetaminophen RnY/GB RnY/GB Before Sx After Sx Metabolite 1.176728 2.852039 14.33873 6.798669 Asparagine Phenyl sulfate 1.31608 2.222061 5-[2-(hydroxymethyl)-5-methylphenoxy]-2,2dimethyl-Pentanoic acid (Gemfibrozil M4) 1.966002 1.079641 0.932653 0.786977 0.782593 1.323149 4.808725 2.107524 2.097368 1.984876 1.876784 1.874516 1.744332 1.620464 2-Hydroxyethinylestradiol docusate beta-D-Fucose Lactate D-Glucose Citric acid trihydroxyoctadecenoic acid 1.340463 1.536745 1D-Myo-inositol 1,3,4,5-tetrakisphosphate 1.703495 0.91429 1.844499 1.77825 1.656207 0.461833 1.271909 1.519994 1.479224 1.468781 1.444315 1.142015 1.083051 1.054801 2-Aminopropiophenone hydroxy capric acid 2-Hydroxymestranol Pro Lys Pro Glu His Creatine Mono-N-depropylprobenecid 1.152962 1.479468 1.050375 1.041754 GPEtn(16:0/22:4(7Z,10Z,13Z,16Z)) Ribitol 1.221211 1.035339 1-eicosanoyl-2-(11Z,14Z-eicosadienoyl)-snglycerol 0.829258 1.020315 0.947206 0.943904 GPEtn(18:0/18:3(9Z,12Z,15Z))[U] D-Glucose 2.105966 0.764784 6,9-hexadecadienoic acid 1.014266 0.886469 0.763771 0.75287 N-(2-phenoxy-ethyl) arachidonoyl amine Allopregnanalone sulfate 0.872243 0.668707 0.672242 0.706845 0.660295 1.681267 1.637326 0.722102 0.67994 0.637524 0.633441 0.600171 0.596823 0.583346 GPEtn(18:1(11Z)/18:1(9Z))[U] Dihydrodipicolinic acid Amiloride undecenoic acid Glutamic Acid Arginine Lauric acid 0.286136 0.93842 1.992268 0.569132 0.533196 0.510135 2-Hydroxy-3-(4-methoxyethylphenoxy)propanoic acid GPIns(18:1(9Z)/18:1(9Z)) GPCho(O-12:0/O-12:0[U]) 2.034236 0.487977 1-(9Z-hexadecenoyl)-2-(9Z,12Zheptadecadienoyl)-sn-glycerol 0.602441 0.428638 Methylprednisolone succinate 0.191259 0.410316 2,4-Dihydroxybutyric acid 24 Potential effects of increased dietary protein to enhance weight loss Amino Acid Effects • Postprandial meal-induced visceral signals • Release of PYY and other enteric hormones • Vagal nerve stimulation • Direct action of amino acids in the brain Tome et al. Am J Clin Nutr 2009;90(suppl):838S–43 25 Mixed Meal Tolerance Test: Pre and Post Weight Loss 300 Leucine (mM) 250 200 150 100 50 0 Lean Obese Pre VLCD Obese Post VLCD Each represents the time course of the indicated metabolite/hormone following administration of 250 ml of Ensure as a mixed meal tolerance test (0,30,60,90,150 minutes) Obese PreSx Obese PostSx 26 Mixed Meal Tolerance Test: Pre and Post Weight Loss 27 Mixed Meal Tolerance Test: Amino Acid Dynamics 28 Change in Amino Acid dynamics following Roux-en-Y gastric bypass Peak Insulin Tryptophan 2 Tyrosine 1.5 Histidine Lysine Ornithine Glucose Alanine Glycine 1 Valine 0.5 Leucine 0 Glutamine Isoleucine Phenylalanine Threonine Glutamic acid Serine 4-Hydroxyproline Proline Methionine Asparagine Aspartic Acid AUC Insulin Tryptophan 2 Tyrosine 1.5 Histidine Lysine Ornithine Glucose Alanine Glycine 1 Valine 0.5 Leucine 0 Glutamine Isoleucine Phenylalanine Glutamic acid Threonine Serine 4-Hydroxyproline Proline Methionine Asparagine Aspartic Acid 29 Cerebral Spinal Fluid Amino Acids MEAL SNACK Bateman et al. Nat. Med. 12:856-861, 2006 Clock Time 30 Can the CSF protect its amino acid levels? • Assess Plasma and CSF Amino Acid and Lipid Profiles at baseline and following 10% weight loss. Defined Diet for 72 hrs. prior to sampling. Amino Acid Fats 2.5 Ratio CSF D /Plasma D • 2.0 1.5 Baseline BMI 26.6 30.8 42.7 57.3 1.0 0.5 0.0 31 Obese individuals have elevated plasma levels of amino acids (and other nutrients) Hypothesis 1.The brain requires a certain amount of nutrients to feel ‘sated’. 2. Amino acids and/or lipids may provide part of the signal. 3. People eat until the nutrient level in the brain is adequate. 4. Overweight and obese individuals need to eat more to get to the ‘ok’ level in the brain…thus have higher nutrient levels in the blood. 5. Weight loss decreases brain levels of nutrients, increasing appetite Amino Acid Amino Acid Fats Fats 32 Summary Metabolomic measurements can provide clues to the dynamic relationship between genes and environment in people The metabolome is complex and changes appear coordinated Statistical and visualization methods can provide otherwise hidden relationships between phenotypic characteristics 33