Emerging Quantitative Targeted Metabolomics Approaches for Future Inborn Errors of Metabolism Screening

Inborn errors of metabolism (IEMs) are a group of inherited genetic conditions that, in general, result from a specific enzyme defect. Clinical consequences caused by abnormal enzyme levels often disrupt affected metabolic pathways and their intermediary metabolites. Because diagnostic outcomes depend on early intervention, a timely and accurate diagnosis is essential. Quantitative targeted metabolomics (QTM) is an analytical approach that quantifies predefined metabolites and generates interpretable biochemical phenotypes. Instead of focusing solely on screening, expanded QTM methods enable higher coverage with multi-analyte profiling that can provide more comprehensive characterization of disease-associated metabolic perturbations, particularly in IEMs with overlapping biochemical profiles. This review summarizes diagnostic techniques for IEMs, outlines the principles and advantages of QTM, and evaluates its established role and emerging opportunities and limitations in advancing method development and deep metabolic phenotyping to support precision medicine.