Simple and unambiguous method for identifying urinary acylcarnitines using gas chromatography-mass spectrometry

Abstract
Several inherited metabolic disorders, particularly the organic acidurias and acidemias, are often characterised by excretion of acylcarnitines, especially octanoylcarnitine, in the urine. Clinical investigation of such serious disorders ideally requires a rapid, simple and selective method for determining acylcarnitines in urine. Initial results are given here of a method that may approach this ideal. The procedure involves chemical derivatisation, in which the zwitterionic acylcarnitines are cyclised to volatile lactones, and analysis by gas chromatography and gas chromatography-mass spectrometry. Preparation of urine samples by ion-exchange purification and an illustrative application of the proposed method to a clinical sample are also outlined.