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Diagnosis of Creatine Metabolism Disorders by Determining Creatine and Guanidinoacetate in Plasma and Urine

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Clinical Applications of Mass Spectrometry

Part of the book series: Methods in Molecular Biology ((MIMB,volume 603))

Abstract

Creatine metabolism disorders include a creatine transporter deficiency, as well as, deficiencies of two enzymes involved in creatine synthesis, arginine–glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT). Laboratory diagnosis of these disorders relies on the determination of creatine and guanidinoacetate in both plasma and urine. Here we describe a rapid HPLC/MS/MS method for these measurements using a normal phase HILIC column after analyte derivatization.

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References

  1. Monge, C., Beraud, N., Kuznetsov, A.V., Rostovtseva, T., Sackett, D., Schlattner, U., Vendelin, M. and Saks, V.A. (2008) Regulation of respiration in brain mitochondria and synaptosomes: restrictions of ADP diffusion in situ, roles of tubulin, and mitochondrial creatine kinase. Mol Cell Biochem, 318, 147–165.

    Article  CAS  PubMed  Google Scholar 

  2. Saks, V., Kaambre, T., Guzun, R., Anmann, T., Sikk, P., Schlattner, U., Wallimann, T., Aliev, M. and Vendelin, M. (2007) The creatine kinase phosphotransfer network: thermodynamic and kinetic considerations, the impact of the mitochondrial outer membrane and modelling approaches. Subcell Biochem, 46, 27–65.

    Article  PubMed  Google Scholar 

  3. Saks, V., Kuznetsov, A., Andrienko, T., Usson, Y., Appaix, F., Guerrero, K., Kaambre, T., Sikk, P., Lemba, M. and Vendelin, M. (2003) Heterogeneity of ADP diffusion and regulation of respiration in cardiac cells. Biophys J, 84, 3436–3456.

    Article  CAS  PubMed  Google Scholar 

  4. Braissant, O., Bachmann, C. and Henry, H. (2007) Expression and function of AGAT, GAMT and CT1 in the mammalian brain. Subcell Biochem, 46, 67–81.

    Article  PubMed  Google Scholar 

  5. Ganesan, V., Johnson, A., Connelly, A., Eckhardt, S. and Surtees, R.A. (1997) Guanidinoacetate methyltransferase deficiency: new clinical features. Pediatr Neurol, 17, 155–157.

    Article  CAS  PubMed  Google Scholar 

  6. Item, C.B., Stockler-Ipsiroglu, S., Stromberger, C., Muhl, A., Alessandri, M.G., Bianchi, M.C., Tosetti, M., Fornai, F. and Cioni, G. (2001) Arginine:glycine amidinotransferase deficiency: the third inborn error of creatine metabolism in humans. Am J Hum Genet, 69, 1127–1133.

    Article  CAS  PubMed  Google Scholar 

  7. Salomons, G.S., van Dooren, S.J., Verhoeven, N.M., Cecil, K.M., Ball, W.S., Degrauw, T.J. and Jakobs, C. (2001) X-linked creatine-transporter gene (SLC6A8) defect: a new creatine-deficiency syndrome. Am J Hum Genet, 68, 1497–1500.

    Article  CAS  PubMed  Google Scholar 

  8. Stockler, S., Hanefeld, F. and Frahm, J. (1996) Creatine replacement therapy in guanidinoacetate methyltransferase deficiency, a novel inborn error of metabolism. Lancet, 348, 789–790.

    Article  CAS  PubMed  Google Scholar 

  9. Stockler, S., Marescau, B., De Deyn, P.P., Trijbels, J.M. and Hanefeld, F. (1997) Guanidino compounds in guanidinoacetate methyltransferase deficiency, a new inborn error of creatine synthesis. Metabolism, 46, 1189–1193.

    Article  CAS  PubMed  Google Scholar 

  10. van der Knaap, M.S., Verhoeven, N.M., Maaswinkel-Mooij, P., Pouwels, P.J., Onkenhout, W., Peeters, E.A., Stockler-Ipsiroglu, S. and Jakobs, C. (2000) Mental retardation and behavioral problems as presenting signs of a creatine synthesis defect. Ann Neurol, 47, 540–543.

    Google Scholar 

  11. Schulze, A., Hess, T., Wevers, R., Mayatepek, E., Bachert, P., Marescau, B., Knopp, M.V., De Deyn, P.P., Bremer, H.J. and Rating, D. (1997) Creatine deficiency syndrome caused by guanidinoacetate methyltransferase deficiency: diagnostic tools for a new inborn error of metabolism. J Pediatr, 131, 626–631.

    Article  CAS  PubMed  Google Scholar 

  12. Cheillan, D., Salomons, G.S., Acquaviva, C., Boisson, C., Roth, P., Cordier, M.P., Francois, L., Jakobs, C. and Vianey-Saban, C. (2006) Prenatal diagnosis of guanidinoacetate methyltransferase deficiency: increased guanidinoacetate concentrations in amniotic fluid. Clin Chem, 52, 775–777.

    Article  CAS  PubMed  Google Scholar 

  13. Braissant, O. and Henry, H. (2008) AGAT, GAMT and SLC6A8 distribution in the central nervous system, in relation to creatine deficiency syndromes: A review. J Inherit Metab Dis.

    Google Scholar 

  14. Guimbal, C. and Kilimann, M.W. (1993) A Na(+)-dependent creatine transporter in rabbit brain, muscle, heart, and kidney. cDNA cloning and functional expression. J Biol Chem, 268, 8418–8421.

    CAS  PubMed  Google Scholar 

  15. Clark, A.J., Rosenberg, E.H., Almeida, L.S., Wood, T.C., Jakobs, C., Stevenson, R.E., Schwartz, C.E. and Salomons, G.S. (2006) X-linked creatine transporter (SLC6A8) mutations in about 1% of males with mental retardation of unknown etiology. Hum Genet, 119, 604–610.

    Article  CAS  PubMed  Google Scholar 

  16. Rosenberg, E.H., Almeida, L.S., Kleefstra, T., deGrauw, R.S., Yntema, H.G., Bahi, N., Moraine, C., Ropers, H.H., Fryns, J.P., deGrauw, T.J. et al. (2004) High prevalence of SLC6A8 deficiency in X-linked mental retardation. Am J Hum Genet, 75, 97–105.

    Article  CAS  PubMed  Google Scholar 

  17. Salomons, G.S., van Dooren, S.J., Verhoeven, N.M., Marsden, D., Schwartz, C., Cecil, K.M., DeGrauw, T.J. and Jakobs, C. (2003) X-linked creatine transporter defect: an overview. J Inherit Metab Dis, 26, 309–318.

    Article  CAS  PubMed  Google Scholar 

  18. Bodamer, O.A., Sahoo, T., Beaudet, A.L., O'Brien, W.E., Bottiglieri, T., Stockler-Ipsiroglu, S., Wagner, C. and Scaglia, F. (2005) Creatine metabolism in combined methylmalonic aciduria and homocystinuria. Ann Neurol, 57, 557–560.

    Article  CAS  PubMed  Google Scholar 

  19. Buist, N.R., Glenn, B., Vugrek, O., Wagner, C., Stabler, S., Allen, R.H., Pogribny, I., Schulze, A., Zeisel, S.H., Baric, I. et al. (2006) S-adenosylhomocysteine hydrolase deficiency in a 26-year-old man. J Inherit Metab Dis, 29, 538–545.

    Article  CAS  PubMed  Google Scholar 

  20. Arias, A., Ormazabal, A., Moreno, J., Gonzalez, B., Vilaseca, M.A., Garcia-Villoria, J., Pampols, T., Briones, P., Artuch, R. and Ribes, A. (2006) Methods for the diagnosis of creatine deficiency syndromes: a comparative study. J Neurosci Methods, 156, 305–309.

    Article  CAS  PubMed  Google Scholar 

  21. Bodamer, O.A., Bloesch, S.M., Gregg, A.R., Stockler-Ipsiroglu, S. and O'Brien, W.E. (2001) Analysis of guanidinoacetate and creatine by isotope dilution electrospray tandem mass spectrometry. Clin Chim Acta, 308, 173–178.

    Article  CAS  PubMed  Google Scholar 

  22. Struys, E.A., Jansen, E.E., ten Brink, H.J., Verhoeven, N.M., van der Knaap, M.S. and Jakobs, C. (1998) An accurate stable isotope dilution gas chromatographic-mass spectrometric approach to the diagnosis of guanidinoacetate methyltransferase deficiency. J Pharm Biomed Anal, 18, 659–665.

    Article  CAS  PubMed  Google Scholar 

  23. Young, S., Struys, E. and Wood, T. (2007) Quantification of creatine and guanidinoacetate using GC-MS and LC-MS/MS for the detection of cerebral creatine deficiency syndromes. Curr Protoc Hum Genet, Chapter 17, Unit 17 13.

    Google Scholar 

  24. Valongo, C., Cardoso, M.L., Domingues, P., Almeida, L., Verhoeven, N., Salomons, G., Jakobs, C. and Vilarinho, L. (2004) Age related reference values for urine creatine and guanidinoacetic acid concentration in children and adolescents by gas chromatography-mass spectrometry. Clin Chim Acta, 348, 155–161.

    Article  CAS  PubMed  Google Scholar 

  25. Derave, W., Marescau, B., Vanden Eede, E., Eijnde, B.O., De Deyn, P.P. and Hespel, P. (2004) Plasma guanidino compounds are altered by oral creatine supplementation in healthy humans. J Appl Physiol, 97, 852–857.

    Article  CAS  PubMed  Google Scholar 

  26. Threlfall, C.J., Maxwell, A.R. and Stoner, H.B. (1984) Post-traumatic creatinuria. J Trauma, 24, 516–523.

    Article  CAS  PubMed  Google Scholar 

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Sun, Q., O’Brien, W.E. (2010). Diagnosis of Creatine Metabolism Disorders by Determining Creatine and Guanidinoacetate in Plasma and Urine. In: Garg, U., Hammett-Stabler, C. (eds) Clinical Applications of Mass Spectrometry. Methods in Molecular Biology, vol 603. Humana Press. https://doi.org/10.1007/978-1-60761-459-3_17

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  • DOI: https://doi.org/10.1007/978-1-60761-459-3_17

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  • Print ISBN: 978-1-60761-458-6

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