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Diagnostic properties of metabolic perturbations in rheumatoid arthritis

Rasmus K Madsen1, Torbjörn Lundstedt23, Jon Gabrielsson3, Carl-Johan Sennbro4, Gerd-Marie Alenius5, Thomas Moritz6, Solbritt Rantapää-Dahlqvist5 and Johan Trygg1*

Author Affiliations

1 Computational Life Science Cluster (CLiC), Department of Chemistry, Umeå University, SE-90187 Umeå, Sweden

2 Department of Medicinal Chemistry, BMC, Uppsala University, SE-75123 Uppsala, Sweden

3 AcureOmics, Tvistevägen 48, SE-90736 Umeå, Sweden

4 Active Biotech Research, Scheelevägen 22, SE-22007 Lund, Sweden

5 Department of Public Health and Clinical Medicine, Rheumatology, Umeå University Hospital, Umeå, Sweden

6 Umeå Plant Science Center, Swedish University of Agricultural Sciences, SE-90183 Umeå, Sweden

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Arthritis Research & Therapy 2011, 13:R19  doi:10.1186/ar3243

Published: 8 February 2011



The aim of this study was to assess the feasibility of diagnosing early rheumatoid arthritis (RA) by measuring selected metabolic biomarkers.


We compared the metabolic profile of patients with RA with that of healthy controls and patients with psoriatic arthritis (PsoA). The metabolites were measured using two different chromatography-mass spectrometry platforms, thereby giving a broad overview of serum metabolites. The metabolic profiles of patient and control groups were compared using multivariate statistical analysis. The findings were validated in a follow-up study of RA patients and healthy volunteers.


RA patients were diagnosed with a sensitivity of 93% and a specificity of 70% in a validation study using detection of 52 metabolites. Patients with RA or PsoA could be distinguished with a sensitivity of 90% and a specificity of 94%. Glyceric acid, D-ribofuranose and hypoxanthine were increased in RA patients, whereas histidine, threonic acid, methionine, cholesterol, asparagine and threonine were all decreased compared with healthy controls.


Metabolite profiling (metabolomics) is a potentially useful technique for diagnosing RA. The predictive value was without regard to the presence of antibodies against cyclic citrullinated peptides.