Urinary organic acid analysis in preventive health assessment and healthy-aging research: A state-of-the-art review of evidence and methodological limitations
- 1Limbach Research Institute for Preventive Diagnostics and Healthy Aging, German University of Health & Sport (DHGS), Ismaning, 85737, Germany
- 2Department of Sport Science, German University of Health & Sport (DHGS), Ismaning, 85737, Germany
Abstract
Urinary organic acid (UOA) testing has established diagnostic applications in inherited metabolic disorders, but its relevance to preventive health assessment and healthy-aging research requires critical evaluation. This state-of-the-art review examines adult human evidence while distinguishing clinical organic acid testing, commercial panels, and targeted or untargeted urinary metabolomics. Eight complementary PubMed searches, supplemented by targeted reference-list checking, yielded 3054 unique records for title and abstract screening. Data from 38 human-study reports, including population characteristics, analytical methods, metabolites, outcomes, confounder adjustment, evaluation procedures, and study limitations, were extracted and synthesized narratively. Analytical and normalization strategies, interpretative limitations, and multi-omics approaches were critically appraised, distinguishing biological associations and exploratory prediction from validated clinical utility. Across the reviewed studies, urinary metabolite profiles were associated with adiposity, metabolic syndrome, renal outcomes, microbial features, and aging-related phenotypes. Evidence ranged from small cross-sectional investigations to population cohorts and prospective analyses, with independent-cohort replication of selected associations and external evaluation of selected predication models. Prospective findings concerned specific populations and outcomes, whereas aging-related evidence included both positive and null findings. Renal handling, sampling conditions, normalization, and analytical heterogeneity complicated comparisons across studies. Multi-omics investigations supported biological interpretation and exploratory prediction, but the reviewed studies did not establish that UOA-guided assessment improves preventive or healthy-aging outcomes. UOA testing has established diagnostic value in inherited metabolic disorders, while emerging human evidence supports further investigation of its relevance to preventive health assessment and healthy-aging research. Translation into routine care requires assay-specific validation and evidence that test-guided assessment or intervention improves clinically meaningful outcomes.
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BibTeX
@article{schauer2026urinary,
title = {{Urinary organic acid analysis in preventive health assessment and healthy-aging research: A state-of-the-art review of evidence and methodological limitations}},
author = {Markus Schauer and Susanne Mair and Mohamad Motevalli and Florian Kainz and Katharina Wirnitzer},
journal = {Metabolism Open},
year = {2026},
month = oct,
doi = {10.1016/j.metop.2026.100511},
url = {https://doi.org/10.1016/j.metop.2026.100511},
note = {CC BY},
}
RIS
TY - JOUR
TI - Urinary organic acid analysis in preventive health assessment and healthy-aging research: A state-of-the-art review of evidence and methodological limitations
AU - Markus Schauer
AU - Susanne Mair
AU - Mohamad Motevalli
AU - Florian Kainz
AU - Katharina Wirnitzer
PY - 2026
DA - 2026/10/15
JO - Metabolism Open
DO - 10.1016/j.metop.2026.100511
UR - https://doi.org/10.1016/j.metop.2026.100511
AB - Urinary organic acid (UOA) testing has established diagnostic applications in inherited metabolic disorders, but its relevance to preventive health assessment and healthy-aging research requires critical evaluation. This state-of-the-art review examines adult human evidence while distinguishing clinical organic acid testing, commercial panels, and targeted or untargeted urinary metabolomics. Eight complementary PubMed searches, supplemented by targeted reference-list checking, yielded 3054 unique records for title and abstract screening. Data from 38 human-study reports, including population characteristics, analytical methods, metabolites, outcomes, confounder adjustment, evaluation procedures, and study limitations, were extracted and synthesized narratively. Analytical and normalization strategies, interpretative limitations, and multi-omics approaches were critically appraised, distinguishing biological associations and exploratory prediction from validated clinical utility. Across the reviewed studies, urinary metabolite profiles were associated with adiposity, metabolic syndrome, renal outcomes, microbial features, and aging-related phenotypes. Evidence ranged from small cross-sectional investigations to population cohorts and prospective analyses, with independent-cohort replication of selected associations and external evaluation of selected predication models. Prospective findings concerned specific populations and outcomes, whereas aging-related evidence included both positive and null findings. Renal handling, sampling conditions, normalization, and analytical heterogeneity complicated comparisons across studies. Multi-omics investigations supported biological interpretation and exploratory prediction, but the reviewed studies did not establish that UOA-guided assessment improves preventive or healthy-aging outcomes. UOA testing has established diagnostic value in inherited metabolic disorders, while emerging human evidence supports further investigation of its relevance to preventive health assessment and healthy-aging research. Translation into routine care requires assay-specific validation and evidence that test-guided assessment or intervention improves clinically meaningful outcomes.
SN - 2589-9368
ER -