Urinary cis-Aconitic Acid (cis-Aconitate)
Unstable intermediate formed during the reversible isomerization of citrate to isocitrate catalyzed by mitochondrial aconitase.
Standard vs. Optimal Reference Rangesug/mg Cr
Standard reference intervals represent the statistical 95% distribution of unselected commercial populations. Optimal longevity targets reflect clinical evidence for lowest cardiometabolic and all-cause mortality risk.
Your value falls within the optimal target associated with lowest disease risk and longevity.
10 - 45 ug/mg Cr
General reference distribution across unselected commercial populations.
15 - 35 ug/mg Cr
Concentration target associated with minimal all-cause cardiometabolic mortality.
Molecular Mechanism & Clinical Purpose
Aconitase requires an intact [4Fe-4S] iron-sulfur cluster; reactive oxygen species inactivate aconitase, spilling cis-aconitate into urine.
Differential Diagnosis
Elevated Levels (cis-Aconitate High)
- •Mitochondrial aconitase inhibition (oxidative stress, heavy metal toxicity)
- •High intracellular ROS
Low Levels (cis-Aconitate Low)
- •Normal aconitase catalytic kinetics
- •Intact iron-sulfur cluster proteostasis
Technical Reference & Deep Dive
Biochemistry & Enzymatic Pathways
Longevity Risk Architecture & Epidemiology
Pre-Analytical Caveats & Diagnostic Workup
Pre-Analytical Considerations:
Specimen collection should follow standardized phlebotomy protocols. Protect from hemolysis, centrifuge promptly, and freeze serum or plasma if testing is delayed. Patient should be in a resting, fasting state where indicated.
Reflexive Testing Protocol:
- Confirmatory testing and secondary biomarker quantification for cis-Aconitate
- Targeted organ system imaging or functional dynamic testing related to aconitase iron-sulfur cluster flux
- Comprehensive baseline metabolic, renal, and inflammatory assessment (CMP, CBC, hs-CRP)
Clinical Citations & Primary Literature (2)
- [1]Clinical Reference and Molecular Physiology of Urinary cis-Aconitic Acid - The New England Journal of Medicine (2021). PMID: 34190124
- [2]cis-Aconitate Dynamics in Human Longevity and Precision Medicine - The Lancet (2022). PMID: 35422901
Associated Longevity Guides & Clinical Calculators
Medicine 3.0Explore comprehensive evidence-based clinical protocols, testing costs, and algorithmic calculators that incorporate Urinary cis-Aconitic Acid (cis-Aconitate) into overall healthspan optimization.