Evidence map›Paper›PMID 27573827›Full record

ArticleProceedings of the National Academy of Sciences of the United States of America2016

Metabolic features of chronic fatigue syndrome.

Robert K Naviaux, Jane C Naviaux, Kefeng Li, A Taylor Bright, William A Alaynick, Lin Wang, Asha Baxter, Neil Nathan, Wayne Anderson, Eric Gordon

Erratum issuedOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Proceedings of the National Academy of Sciences of the United States of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 260 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
260citing papers in PubMed, 9 pooled it
25.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

260 citing papers in PubMed, 9 syntheses or guidelines pooled it, 411 citations in OpenAlex.

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  13. Towards a domain-general mechanistic model of fatigue: application to Functional Neurological Disorder.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2026
    Review
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200 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Robert K NaviauxThe Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Pathology, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; rnaviaux@ucsd.edu.
Jane C NaviauxThe Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Neurosciences, University of California, San Diego School of Medicine, San Diego, CA 92103-8467;
Kefeng LiThe Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467;
A Taylor BrightThe Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467;
William A AlaynickThe Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467;
Lin WangThe Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467;
Asha BaxterGordon Medical Associates, Santa Rosa, CA 95403.
Neil NathanGordon Medical Associates, Santa Rosa, CA 95403.
Wayne AndersonGordon Medical Associates, Santa Rosa, CA 95403.
Eric GordonGordon Medical Associates, Santa Rosa, CA 95403.
University of California, San Diego · USMedical Research Associates · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

More than 2 million people in the United States have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We performed targeted, broad-spectrum metabolomics to gain insights into the biology of CFS. We studied a total of 84 subjects using these methods. Forty-five subjects (n = 22 men and 23 women) met diagnostic criteria for ME/CFS by Institute of Medicine, Canadian, and Fukuda criteria. Thirty-nine subjects (n = 18 men and 21 women) were age- and sex-matched normal controls. Males with CFS were 53 (±2.8) y old (mean ± SEM; range, 21-67 y). Females were 52 (±2.5) y old (range, 20-67 y). The Karnofsky performance scores were 62 (±3.2) for males and 54 (±3.3) for females. We targeted 612 metabolites in plasma from 63 biochemical pathways by hydrophilic interaction liquid chromatography, electrospray ionization, and tandem mass spectrometry in a single-injection method. Patients with CFS showed abnormalities in 20 metabolic pathways. Eighty percent of the diagnostic metabolites were decreased, consistent with a hypometabolic syndrome. Pathway abnormalities included sphingolipid, phospholipid, purine, cholesterol, microbiome, pyrroline-5-carboxylate, riboflavin, branch chain amino acid, peroxisomal, and mitochondrial metabolism. Area under the receiver operator characteristic curve analysis showed diagnostic accuracies of 94% [95% confidence interval (CI), 84-100%] in males using eight metabolites and 96% (95% CI, 86-100%) in females using 13 metabolites. Our data show that despite the heterogeneity of factors leading to CFS, the cellular metabolic response in patients was homogeneous, statistically robust, and chemically similar to the evolutionarily conserved persistence response to environmental stress known as dauer.

Indexed as

cell danger responsechronic fatigue syndromedauermetabolomicsmitochondria

Identifiers

PMID27573827
PMCPMC5027464
OpenAlexW2509132807

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.