Serum metabolomics reveals the effect of electroacupuncture on urinary leakage in women with stress urinary incontinence.

Stress urinary incontinence (SUI), which is defined as an involuntary loss of urine upon physical exertion coughing, sneezing or laughing, has a significant negative impact on the quality of life of many women. Multi-center, large-scale and randomized clinical trials have illustrated that non-invasive electroacupuncture is an effective treatment for SUI, but its therapeutic mechanism in treating SUI remains unknown. Here, gas chromatography-mass spectrometry based serum metabolomics was performed to reveal metabolic profiles and diagnostic biomarkers from recruitment of 25 patients and 25 healthy women before and after electroacupuncture. We identified 10 differentially abundant metabolites, including butantriol, 3,4-dihydroxybutanoic acid, succinic acid, 1-deoxypentitol, psicose, citric acid, 3-hydroxybutyric acid, hydracrylic acid, 3-hydroxyphenylacetic acid and D-mannitol, from patients between before and after electroacupuncture. The electroacupuncture therapy altered propanoate metabolism, butanoate metabolism and the tricarboxylic acid cycle. A panel of 8 biomarkers (butantriol, 3,4-dihydroxybutanoic acid, succinic acid, 1-deoxypentitol, psicose, citric acid, 3-hydroxybutyric acid and hydracrylic acid) was evaluated to determine the effect of electroacupuncture on SUI and differentiated well between before and after treatment. The area under the receiver operating characteristic curve was 0.962. The sensitivity, specificity and coincidence rate were 92 %, 92 % and 96 %, respectively, at a 95 % confidence interval ranging from 0.9053 to 1. Furthermore, the levels of these diagnostic biomarkers were not significantly altered in healthy subjects after sham electroacupuncture. It was indicated that an 8-biomarker panel might be constructed for the therapeutic evaluation of electroacupuncture treatment for SUI.