Serum Metabolomic Profiling of Liver Cirrhosis Patients Using NMR Spectroscopy in Lagos State

Liver cirrhosis produces widespread metabolic perturbations detectable in serum metabolomics, and NMR-based metabolomic profiling of cirrhosis patients provides an integrated biochemical characterisation of disease-associated metabolic reprogramming beyond what is captured by conventional liver function tests. This study performs serum metabolomic profiling of liver cirrhosis patients using proton NMR spectroscopy at Lagos University Teaching Hospital. Fifty liver cirrhosis patients classified by Child-Pugh score (17 Class A, 21 Class B, 12 Class C) and fifty age- and sex-matched healthy controls were enrolled. Serum samples were processed and analysed by one-dimensional 1H-NMR spectroscopy at 600 MHz. Spectral pre-processing, bucketing, and normalization were applied before multivariate statistical analysis by principal component analysis and orthogonal partial least squares discriminant analysis. Metabolite identification was performed using the Human Metabolome Database and Chenomx NMR Suite. Results reveal clear metabolic separation between cirrhosis patients and controls by OPLS-DA. Thirty-one metabolites were significantly altered in cirrhosis, including branched-chain amino acids (significantly reduced), aromatic amino acids (significantly elevated), glucose (elevated), lactate (elevated), acetate (elevated), citrate (reduced), and trimethylamine N-oxide (elevated). The branched-chain amino acid to aromatic amino acid molar ratio was progressively reduced with advancing Child-Pugh class, confirming its biochemical utility as a disease severity indicator. Metabolic pathway analysis implicated disrupted amino acid metabolism, tricarboxylic acid cycle impairment, and altered gut microbiome-liver axis metabolite production as primary disease-associated biochemical signatures. Keywords: metabolomics, NMR spectroscopy, liver cirrhosis, serum metabolites, Lagos State.