College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Republic of Korea.
Department of Family Medicine, Daegu Catholic University Medical Center, Daegu, Republic of Korea.
Diabetes Res Clin Pract. 2018 Jun;140:216-227. doi: 10.1016/j.diabres.2018.03.045. Epub 2018 Apr 4.
Fasting plasma glucose, oral glucose tolerance test, and glycated hemoglobin are diagnostic markers for type 2 diabetes mellitus (T2DM). However, it is necessary to detect physiological changes in T2DM rapidly and stratify diabetic stage using other biomarkers. We performed a systematic review and meta-analysis to contribute to the development of objective and sensitive diagnostic indicators by integrating metabolite biomarkers derived from large-scale cohort studies.
We searched for metabolomics studies of T2DM cohort in PubMed, Scopus, and Web of Science for studies published within the last 10 years from January 2008 to February 2017. The concentrations of metabolites and odds ratios (ORs) were integrated and risk ratio (RR) values were estimated to distinguish subjects with T2DM and normal participants.
Fourteen cohort studies were investigated in this meta-analysis. There were 4592 patients in the case group and 11,492 participants in the control group. We noted a 1.89-, 1.63-, and 1.87-fold higher risk of T2DM associated with leucine (RR 1.89 [95% CI 1.57-2.29]), alanine (RR 1.63 [95% CI 1.48-1.79]), and oleic acid (RR 1.87 [95% CI 1.62-2.17]), respectively. Lysophosphatidylcholine C18:0 (RR 0.80 [95% CI 0.72-0.90]) and creatinine (RR 0.63 [95% CI 0.53-0.74]) were associated with 20% and 37% decreased T2DM risks, respectively.
Most amino acids in patients were positively related to diabetes, while creatinine and some lysophosphatidylcholines showed a negative relationship. This suggests that diabetic risk prediction using metabolites that sensitively reflect changes in the body will improve individual diagnosis and personalize medicine.
空腹血糖、口服葡萄糖耐量试验和糖化血红蛋白是 2 型糖尿病（T2DM）的诊断标志物。然而，有必要使用其他生物标志物快速检测 T2DM 的生理变化并对糖尿病阶段进行分层。我们进行了系统评价和荟萃分析，通过整合来自大规模队列研究的代谢物生物标志物，为开发客观和敏感的诊断指标做出贡献。
我们在 PubMed、Scopus 和 Web of Science 中搜索了 2008 年 1 月至 2017 年 2 月期间发表的 T2DM 队列代谢组学研究，纳入了 14 项队列研究。整合了代谢物的浓度和比值比（OR），并估计了风险比（RR）值，以区分 T2DM 患者和正常参与者。
这项荟萃分析纳入了 14 项队列研究。病例组有 4592 名患者，对照组有 11492 名参与者。我们发现亮氨酸（RR 1.89 [95%CI 1.57-2.29]）、丙氨酸（RR 1.63 [95%CI 1.48-1.79]）和油酸（RR 1.87 [95%CI 1.62-2.17]）与 T2DM 的关联风险分别高出 1.89 倍、1.63 倍和 1.87 倍。溶血磷脂酰胆碱 C18：0（RR 0.80 [95%CI 0.72-0.90]）和肌酐（RR 0.63 [95%CI 0.53-0.74]）与 20%和 37%的 T2DM 风险降低相关。
患者的大多数氨基酸与糖尿病呈正相关，而肌酐和一些溶血磷脂酰胆碱呈负相关。这表明使用能够灵敏反映体内变化的代谢物进行糖尿病风险预测将改善个体诊断并实现个体化医疗。
