The Assessment of the Energy Metabolism in Patients with Chronic Fatigue Syndrome by Serum Fluorescence Emission
- Source: Alternative Therapies in Health and Medicine, Jan-Feb 2012
By Nina Mikirova, Joseph Casciari, Ronald Hunninghake
[Note: The fatigue marker discussed here is NAD(P)H, the reduced form of the coenzyme NADP. It can be measured via the level of its fluorescence when blood serum is irradiated. In a previous study these researchers found that lower concentrations of NAD(P)H were indicative of reduced energy metabolism in cancer patients. The full text PDF of this article is available free at www.riordanclinic.org/research/articles/AT-2012-v18.pdf.]
Context: Chronic fatigue syndrome (CFS) is a debilitating fatigue illness that has unknown etiology and lacks an objective diagnostic marker.
Objective: To examine the metabolic component of CFS to determine if practitioners can use serum NAD(P)H concentration measurements to monitor metabolism and fatigue status in patients with CFS.
Design: The research team conducted a case-control study, comparing a group of patients who were diagnosed with CFS with a control group of healthy subjects. The team obtained venous blood samples from fasting patients to examine the serum NAD(P)H concentrations.
Setting: The study occurred at the Riordan Clinic in Witchita, Kansas.
Participants: The study included 44 CFS patients at the Riordan Clinic and 30 healthy control participants.
The CFS patients presented a spectrum of symptoms that had existed for at least 6 months: new, unexplained, persistent, or relapsing chronic fatigue that bed rest did not resolve and that was severe enough to reduce daily activity significantly - by 50% - in conjunction with headache, muscle pain, pain in multiple joints, and unrefreshing sleep.
In the control group, the research team enrolled subjects without diagnosis of disease or injury.
Outcome Measures: The research team determined levels of serum reduced nicotinamide adenine dinucleotides (NADH and NAD[P]H) by measuring serum fluorescence emission at 450 nm. The team then conducted sensitivity and specificity analyses.
• NAD(P)H concentrations in serum of CFS participants averaged 8.0 +/- 1.4 (standard deviation [SD]) nmol/mL,
• While those in the healthy controls averaged 10.8 +/- 0.8 (SD) nmol/mL, a statistically significant difference.
Using a cut-off concentration of 9.5 nmol/mL, the research team attained a sensitivity of 0.73 and a specificity of 1.0. An analysis of receiver-operator characteristics yielded an area under the curve of 0.9.
The research team compared serum NAD(P)H to several endocrine and metabolic lab parameters. Serum NAD(P)H was directly correlated with serum CoQ10 levels and inversely correlated with urine hydroxyhemopyrrolin-2-one levels.
Conclusions: Based on these findings, the research team proposed using serum NAD(P)H, measured as an intrinsic serumfluorescence emission, to monitor metabolism and fatigue status in patients with CFS.
Following patients’ NAD(P)H levels over time may aid in selecting therapeutic strategies and monitoring treatment outcomes.
Source: Alternative Therapies, Jan-Feb 2012;18(1):36-40. ISSN#10786791 Mikirova N, Casciari J, Hunninghake R. Riordan Clinic, Wichita, Kansas, USA. [Email: firstname.lastname@example.org]