The initial stages of liver damage can be difficult to detect using standard
clinical and imaging diagnostic tests. Prior to the development of advanced fibrosis or
liver failure, the diseased liver may abnormally metabolise nutrients and drugs. Such
changes can be measured by differences in low molecular weight metabolites in body
fluids using a range of state-or-the-art analytical chemistry methods, including proton
nuclear magnetic resonance spectroscopy and mass spectrometry. Gut microbial cometabolites,
for example hippurate and trimethylamine-N-oxide, may also be detected
in urine and blood. In this chapter we illustrate results of urinary, plasma and serum
metabolic profiling, using proton nuclear magnetic resonance spectroscopy, for
characterising specific aspects of liver disease and monitoring treatment of liver
cirrhosis.
Keywords: Cirrhosis, Dimethylamine, Gut microbiome, Hepatocellular
carcinoma, Hippurate, Liver disease, Nuclear magnetic resonance spectroscopy,
Phenylacetylglutamine, Trimethylamine, Trimethylamine-N-oxide.