Chi, Ai-Ping, Wang, Zi-Nan, Shi, Bing et al. · Zhongguo ying yong sheng li xue za zhi = Zhongguo yingyong shenglixue zazhi = Chinese journal of applied physiology · 2018 · DOI
This study looked at chemicals in the urine of teenagers with ME/CFS before and after exercise to understand how their bodies process energy differently. Researchers found that people with ME/CFS had abnormal levels of several metabolites (chemical byproducts), and these changes got worse after exercise, suggesting their bodies struggle to recover from physical activity.
This metabolomics study provides biochemical evidence that ME/CFS involves measurable disruptions in energy metabolism and hormone regulation, particularly involving creatine and pantothenic acid pathways—areas relevant to cellular energy production and post-exertional malaise. Understanding these metabolic signatures may eventually help develop objective biomarkers for diagnosis and reveal specific therapeutic targets.
This study does not establish that these metabolic differences cause ME/CFS, only that they associate with the diagnosis. The small sample size (8 per group) and single-session exercise protocol limit generalizability, and metabolite changes may be markers of rather than drivers of pathology. Findings in adolescents may not apply to adult ME/CFS patients.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Chi, Ai-Ping, Wang, Zi-Nan, Shi, Bing, Yang, Xiao-Fan, Min, Rui-Xin, & Song, Jing (2018). [Comparison of differential metabolites in urine of the middle school students with chronic fatigue syndrome before and after exercise].. Zhongguo ying yong sheng li xue za zhi = Zhongguo yingyong shenglixue zazhi = Chinese journal of applied physiology. https://doi.org/10.12047/j.cjap.5633.2018.078
BibTeX
@article{mecfsatlas-chi-2018-comparison-differential,
author = {Chi, Ai-Ping and Wang, Zi-Nan and Shi, Bing and Yang, Xiao-Fan and Min, Rui-Xin and Song, Jing},
title = {[Comparison of differential metabolites in urine of the middle school students with chronic fatigue syndrome before and after exercise].},
journal = {Zhongguo ying yong sheng li xue za zhi = Zhongguo yingyong shenglixue zazhi = Chinese journal of applied physiology},
year = {2018},
doi = {10.12047/j.cjap.5633.2018.078},
note = {PubMed: 30788942},
url = {https://www.mecfsatlas.com/evidence/chi-2018-comparison-differential},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/chi-2018-comparison-differential
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