Beijing Key Laboratory and Joint Laboratory for International Cooperation of Bio-characteristic Profiling for Evaluation of Rational Drug Use, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China.
Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China.
BMC Endocr Disord. 2020 Nov 23;20(1):174. doi: 10.1186/s12902-020-00653-x.
We aimed to explore metabolite biomarkers that could be used to identify pre-diabetes and type 2 diabetes mellitus (T2DM) using systematic review and meta-analysis.
Four databases, the Cochrane Library, EMBASE, PubMed and Scopus were selected. A random effect model and a fixed effect model were applied to the results of forest plot analyses to determine the standardized mean difference (SMD) and 95% confidence interval (95% CI) for each metabolite. The SMD for every metabolite was then converted into an odds ratio to create an metabolite biomarker profile.
Twenty-four independent studies reported data from 14,131 healthy individuals and 3499 patients with T2DM, and 14 included studies reported 4844 healthy controls and a total of 2139 pre-diabetes patients. In the serum and plasma of patients with T2DM, compared with the healthy participants, the concentrations of valine, leucine, isoleucine, proline, tyrosine, lysine and glutamate were higher and that of glycine was lower. The concentrations of isoleucine, alanine, proline, glutamate, palmitic acid, 2-aminoadipic acid and lysine were higher and those of glycine, serine, and citrulline were lower in prediabetic patients. Metabolite biomarkers of T2DM and pre-diabetes revealed that the levels of alanine, glutamate and palmitic acid (C16:0) were significantly different in T2DM and pre-diabetes.
Quantified multiple metabolite biomarkers may reflect the different status of pre-diabetes and T2DM, and could provide an important reference for clinical diagnosis and treatment of pre-diabetes and T2DM.
本研究旨在通过系统评价和荟萃分析，探索可用于识别糖尿病前期和 2 型糖尿病（T2DM）的代谢物生物标志物。
我们选择了 Cochrane 图书馆、EMBASE、PubMed 和 Scopus 这四个数据库。使用随机效应模型和固定效应模型对森林图分析结果进行分析，以确定每种代谢物的标准化均数差（SMD）和 95%置信区间（95%CI）。然后，我们将每个代谢物的 SMD 转换为优势比，以创建代谢物生物标志物图谱。
24 项独立研究报告了来自 14131 名健康个体和 3499 名 T2DM 患者的数据，其中 14 项研究报告了 4844 名健康对照者和总共 2139 名糖尿病前期患者的数据。与健康参与者相比，T2DM 患者的血清和血浆中缬氨酸、亮氨酸、异亮氨酸、脯氨酸、酪氨酸、赖氨酸和谷氨酸的浓度较高，而甘氨酸的浓度较低。在糖尿病前期患者中，异亮氨酸、丙氨酸、脯氨酸、谷氨酸、棕榈酸、2-氨基己二酸和赖氨酸的浓度较高，而甘氨酸、丝氨酸和瓜氨酸的浓度较低。T2DM 和糖尿病前期的代谢物生物标志物显示，丙氨酸、谷氨酸和棕榈酸（C16:0）的水平在 T2DM 和糖尿病前期患者中存在显著差异。
定量的多种代谢物生物标志物可能反映了糖尿病前期和 T2DM 的不同状态，可为糖尿病前期和 T2DM 的临床诊断和治疗提供重要参考。
