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Precision medicine, taking account of human individuality in genes, environment, and lifestyle for early disease diagnosis and
individualized therapy, has shown great promise to transform medical care. Non-targeted metabolomics, with the ability to
detect broad classes of biochemicals, can provide a comprehensive functional phenotype integrating clinical phenotypes with genetic
and non-genetic factors. To test the application of metabolomics in individual diagnosis, we conducted a metabolomics analysis
on plasma samples collected from 80 volunteers of normal health with complete medical records and three-generation pedigrees.
Using a broad-spectrum metabolomics platform consisting of liquid chromatography and GC coupled with MS, we profiled nearly
600 metabolites covering 72 biochemical pathways in all major branches of biosynthesis, catabolism, gut microbiome activities,
and xenobiotics. Statistical analysis revealed a considerable range of variation and potential metabolic abnormalities across the
individuals in this cohort. Examination of the convergence of metabolomics profiles with whole-exon sequences (WESs) provided
an effective approach to assess and interpret clinical significance of genetic mutations, as shown in a number of cases, including
fructose intolerance, xanthinuria, and carnitine deficiency. Metabolic abnormalities consistent with early indications of diabetes,
liver dysfunction, and disruption of gut microbiome homeostasis were identified in several volunteers. Additionally, diverse
metabolic responses to medications among the volunteers may assist to identify therapeutic effects and sensitivity to toxicity. The
results of this study demonstrate that metabolomics could be an effective approach to complement next generation sequencing
(NGS) for disease risk analysis, disease monitoring, and drug management in our goal toward precision care.