Metabolic phenotyping for discovery of urinary biomarkers of diet, xenobiotics and blood pressure in the INTERMAP Study: An overview

The aetiopathogenesis of cardiovascular diseases (CVD) is multifactorial. Adverse blood pressure (BP) is a major independent risk factor for epidemic CVD affecting about 40% of the adult population worldwide and resulting in significant morbidity and mortality. Metabolic phenotyping of biological fluids has proven its application in characterisin g low molecule weight metabolites providing novel insights into gene -environmental -gut microbiome interaction in relations to a disease state. In this review, we synthesi s e key results from the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) Study, a cross - sectional epidemiological study of 4,680 men and women aged 40 -59 years from Japan, the People’s Republic of China, the United Kingdom, and the United States. We describe the advancements we have made on: 1) analytical techniques for high throughput metabolic phenotyping; 2) statistical analyses for biomarker identification; 3) discovery of unique food - specific biomarkers; and 4) application of metabolome -wide association (MWA) studies to gain a better understanding into the molecular mechanisms of cross cultural and regional BP differences.