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Table 3 Quantification of organic acids in plasma and urine

From: The role of previously unmeasured organic acids in the pathogenesis of severe malaria

Characteristics Uncomplicated malaria N=102 Severe malaria N=138 Sepsis N=32 Encephalopathy N=35 P value*
Geo mean (95 % CI, range) Geo mean (95 % CI, range) Geo mean (95 % CI, range) Geo mean (95 % CI, range)
Plasma concentration (μmol/La)          
 LA 1680 (1437–1965, 122–5019) 4912 (4389–5497, 835–27,958) 2615 (1970–3470, 305–11,002) 1898 (1380–2611, 293–17,132) <0.001
 HPLA 4.3 (3.7–5.0, UD–13.0) 10.6 (9.5–11.8, 4.4–124.7) 7.0 (5.4–9.0, UD–30.0) 4.4 (3.4–5.6, UD–15.2) <0.001
 α-HBA 46.0 (34.6–61.0, UD–270.1) 117.7 (106.3–130.4, 30.7–590.1) 88.4 (59.4–131.5, UD–411.3) 86.8 (63.8–118.1, 6.4–419.7) <0.001
 β-HBA 102.7 (91.9–114.8, UD–715.7) 143.9 (128.9–160.5, UD–1620.0) 223.5 (147.4–338.8, UD–2720.0) 146.8 103.9–207.3, UD–1651.0) <0.001
Corrected urine concentrations (μmol/mmol CrCl)a,b   N=78   N=112   N=19   N=26  
 LA 2.85 (2.32–3.49, 0.44–41.77) 12.97 (9.67–17.40, 0.54–1357.22) 13.47 (5.54–32.74, 1.00–555.30) 10.92 (6.05–19.72, 1.45–215.30) <0.001
 HPLA 0.48 (0.34–0.66, 0.01–7.08) 1.61 (1.28–2.04, 0.05–19.61) 1.15 (0.46–2.85, 0.03–17.12) 0.50 (0.29–0.88, UD–5.82) <0.001
 α-HBA 0.63 (0.51–0.78, 0.08–11.86) 1.26 (0.98–1.63, UD–79.63) 1.06 (0.61–1.84, 0.19–17.37) 1.16 (0.91–1.48, 0.36–4.57) <0.001
 β-HBA 2.11 (1.75–2.53, UD–11.99) 3.42 (2.83–4.12, UD–193.30) 5.52 (2.66–11.46, UD–36.28) 3.40 (2.27–5.09, UD–17.11) <0.001
 EMA 0.34 (0.27–0.43, 0.06–17.46) 0.26 (0.21–0.32, UD–9.58) 0.37 (0.0.24–0.57, UD–2.33) 0.36 (0.26–0.49, UD–2.25) 0.145
 MMA 0.23 (0.19–0.28, 0.03–2.85) 0.20 (0.16–0.24, UD–2.97) 0.19 (0.13–0.27, UD–0.45) 0.21 (0.14–0.31, 0.05–4.75) 0.646
 α-KGA 2.25 (1.72–2.95, UD–5.44) 3.18 (2.53–3.98, UD–27.11) 3.52 (1.82–6.82, UD–12.91) 3.89 (2.58–5.86, UD–26.41) 0.128
  1. Abbreviations: LA lactic acid, geo mean geometric mean, HPLA hydroxyphenyllactic acid, α-HBA α-hydroxybutyric acid, β-HBA β-hydroxybutyric acid, EMA ethylmalonic acid, MMA methylmalonic acid, α-KGA α-ketoglutaric acid, CrCl creatinine clearance, UD undetectable
  2. *Acid concentrations were log-transformed toward normality before analysis of variance. For plasma specimens, undetectable concentrations were treated as half the lower limit of detection to allow inclusion in intergroup comparisons. For corrected urine concentrations, undetectable values were treated as half the lowest value calculated from a detectable specimen
  3. aFor all plasma specimens, EMA, MMA, α-KGA and malonic acid (MA) were assayed but undetectable. For all urine specimens, MA was assayed but undetectable
  4. bCorrected urine concentrations were adjusted for impaired creatinine clearance by incorporating the urine/plasma creatinine ratio as described in the Methods section