Bringing metabolic profiling into clinical practice. Linda Mustelin, MD, PhD, MPH Senior Medical Scientist Nightingale Health

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Theodore Cameron
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2 Bringing metabolic profiling into clinical practice Linda Mustelin, MD, PhD, MPH Senior Medical Scientist Nightingale Health

4 Nightingale Health Ltd. Finnish biotech company specialized in comprehensive metabolic profiling Enabling disease prediction and preventive medicine in chronic diseases Roots in peer-reviewed biomedical science blood samples analyzed 100+ scientific publications

5 Our laboratories Nightingale Helsinki & Kuopio University of Oxford Clinical Trial Service Unit University of Bristol MRC Epidemiology

6 NMR-based metabolic profiling platform

7 228 Metabolic Measures Cholesterol (mmol/l) Total cholesterol VLDL cholesterol IDL cholesterol LDL cholesterol HDL cholesterol HDL 2 cholesterol HDL 3 cholesterol Remnant cholesterol Free cholesterol Esteri ed cholesterol Glycerides & phospholipids (mmol/l) Total triglycerides VLDL triglycerides IDL triglycerides LDL triglycerides HDL triglycerides Phosphoglycerides Ratio of triglycerides to phosphoglycerides Total cholines Phosphatidylcholines Sphingomyelins Apolipoproteins (g/l) Apolipoprotein A-I Apolipoprotein B ApoB/ApoA-I Fatty acids and saturation Total fatty acids Estimated degree of unsaturation Fatty acids (mmol/l and % of total FAs) Omega-3 fatty acids Omega-6 fatty acids Polyunsaturated fatty acids Monounsaturated fatty acids Saturated fatty acids Docosahexaenoic acid Linoleic acid Ketone bodies (mmol/l) Acetate Acetoacetate 3-hydroxybutyrate Glycolysis related metabolites (mmol/l) Glucose Lactate Pyruvate* Citrate Glycerol* (* not available for EDTA plasma samples) Fluid balance Creatinine Albumin Inflammation (mmol/l) Glycoprotein acetylation (GlycA) Amino acids (mmol/l) Glycine* Histidine Branched-chain amino acids Isoleucine Leucine Valine Aromatic amino acids Phenylalanine Tyrosine Lipoprotein particle size (nm) Mean diameter of VLDL particles Mean diameter of LDL particles Mean diameter of HDL particles Particle concentration and lipid composition for 14 lipoprotein subclasses Total lipids (mmol/l) Particle concentration (µmol/l) Cholesterol (mmol/l and % of total lipids) Esterified cholesterol (mmol/l and % of total lipids) Free cholesterol (mmol/l and % of total lipids) Triglycerides (mmol/l and % of total lipids) Phospholipids (mmol/l and % of total lipids) Complete list of metabolic measures: nightingalehealth.com/biomarkers

9 Type 2 diabetes risk Jun 12 Aug 2 Dec 11 Current risk level Type 2 diabetes risk Current risk level Heart disease risk Jun 12 Aug 2 Dec 11 Jun 12 Aug 2 Dec 11 Current risk level Phenylalanine Moderate Omega-6 FA Type 2 diabetes risk Jun 12 Aug 2 Dec 11 Current risk level High Total fatty acids 72% of people in your reference group have higher values 51% of people in your reference group have higher values Tyrosine 21% of people in your reference group have higher values 8% of people in your reference group have higher values Better decision-making tools Type 2 diabetes risk Heart disease risk Total fatty acids 72% of people in your reference group have higher values High Jun 12 Aug 2 Dec 11 Jun 12 Aug 2 Dec Current risk level Current risk level 51% of people in your reference group have higher values Tyrosine High High Moderate % of people in your reference group have higher values Phenylalanine 80 Omega-6 FA 2.2 8% of people in your reference group have higher values

10 Nightingale s extended lipid panel Total Cholesterol LDL HDL Triglycerides In addition: Glucose Creatinine ApoA1 ApoB ApoB/ApoA1

11 MD, PhD, MPH Linda Mustelin nightingalehealth.com

Supplementary Figure 1. A correlation matrix of all the Finnish study cohorts with pairwise Spearman s rank correlation. Only correlations with

Supplementary Figure 1. A correlation matrix of all the Finnish study cohorts with pairwise Spearman s rank correlation. Only correlations with P