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=== ME/CFS === {{Main article| page_name=Myalgic encephalomyelitis}} Preliminary data from the [[UK ME/CFS biobank]] show an association between increased risk of ME/CFS and a gene variant that encodes for a subunit of [[prolyl 4-hydroxylase]] subunit alpha 1 (P4HA1), which encodes for [[procollagen-proline dioxygenase]], an enzyme involved in the production of collagen. P4HA1 also plays a role in the regulation of [[energy metabolism]] via downregulation of [[pyruvate dehydrogenase]] during [[hypoxia]].<ref>{{Cite journal | last = Schneider | first = Martin | last2 = Harnoss | first2 = Jonathan Michael | last3 = Strowitzki | first3 = Moritz J. | last4 = Radhakrishnan | first4 = Praveen | last5 = Platzer | first5 = Lisa | last6 = Harnoss | first6 = Julian Camill | last7 = Hank | first7 = Thomas | last8 = Cai | first8 = Jun | last9 = Ulrich | first9 = Alexis | date = Jan 2015 | title = Therapeutic inhibition of prolyl hydroxylase domain-containing enzymes in surgery: putative applications and challenges |url =https://www.dovepress.com/therapeutic-inhibition-of-prolyl-hydroxylase-domain-containing-enzymes-peer-reviewed-fulltext-article-HP | journal = Hypoxia|language=English|volume=3 | pages = 1|doi=10.2147/HP.S60872|issn=2324-1128}}</ref> The data are based on self-reported diagnosis of [[chronic fatigue syndrome]] and involve a sample size that is very small for genome-wide association studies (n=1829), making confidence intervals difficult to estimate.<ref>{{Cite news |url =https://mecfsresearchreview.me/2018/06/11/analysis-of-data-from-500000-individuals-in-uk-biobank-demonstrates-an-inherited-component-to-me-cfs/amp/?__twitter_impression=true | title = Analysis of data from 500,000 individuals in UK Biobank demonstrates an inherited component to ME/CFS | date = 2018-06-11|work=ME/CFS Research Review|access-date=2018-11-11|language=en-US}}</ref> Elevated levels of [[hydroxyproline]], a marker of collagen breakdown, was found by [[Wenzhong Xiao]] in the [[Severely Ill Patient Study]].<ref>{{Citation | last = Open Medicine Foundation - OMF | title = Wenzhong Xiao, PhD {{!}} Results from the Severely Ill Patient Study (SIPS) | date = 2018-11-07 | url = https://www.youtube.com/watch?v=_N1o2gbaCl4&feature=youtu.be&t=853|access-date=2019-07-16}}</ref> [[Robert Naviaux]]’s work has suggested it as a possible [[Diagnostic biomarker|biomarker]] for female [[ME/CFS]] patients.<ref name="Navauix2016">{{Cite journal | last1 = Naviaux | first1 = Robert K. | authorlink = Robert Naviaux | first2 = Jane C. | last2 = Naviaux | author-link2 = | last3 = Kefeng | first3 =Li | first4 = A. Taylor | last4 = Bright | first5 = William A. | last5 = Alaynick | first6 = Lin | last6 = Wang | first7 = Asha | last7 = Baxter | first8 = Neil | last8 = Nathan | first9 = Wayne | last9 = Anderson | first10 = Eric | last10 = Gordon | date = 2016-09-13 | title = Metabolic features of chronic fatigue syndrome | url =https://www.pnas.org/content/113/37/E5472 | journal = Proceedings of the National Academy of Sciences|language=en|volume=113 | issue = 37| pages = E5472–E5480|doi=10.1073/pnas.1607571113|issn=0027-8424|pmid=27573827}}</ref> [[Maureen Hanson]] failed to find elevated hydroxyproline in her metabolomics study.{{Citation needed|reason=}}
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