Department of Forensic Pathology, College of Forensic Medicine, Xi'an Jiaotong University, No. 76 West Yanta Rd., Xi'an, Shaanxi 710061, China; Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, No. 1347 West Guangfu Rd., Shanghai 200063, China.
Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, No. 1347 West Guangfu Rd., Shanghai 200063, China.
Spectrochim Acta A Mol Biomol Spectrosc. 2021 Sep 5;258:119882. doi: 10.1016/j.saa.2021.119882. Epub 2021 Apr 26.
Determination of the cause of death for diabetic ketoacidosis (DKA), a common and fatal acute complication of diabetes mellitus, is a challenging forensic task owing to the lack of characteristic morphological findings at autopsy. In this study, Fourier-transform infrared (FTIR) microspectroscopy coupled with chemometrics was employed to characterize biochemical differences in pulmonary edema fluid from different causes of death to supplement conventional methods and provide an efficient postmortem diagnosis of DKA. With this aim, FTIR spectra in three different situations (DKA-caused death, other causes of death with diabetes history, and other causes of death without diabetes history) were measured. The results of principal component analysis indicated different spectral profiles between these three groups, which mainly exhibited variations in proteins. Subsequently, two binary classification models were established using an algorithm of partial least squares discriminant analysis (PLS-DA) to determine whether decedents had diabetes and whether the diabetic patients died from DKA. Satisfactory prediction results of PLS-DA models demonstrated good differentiation among these three groups. Therefore, it is feasible to make a postmortem diagnosis of DKA and detect diabetes history via FTIR microspectroscopic analysis of the pulmonary edema fluid.
测定糖尿病酮症酸中毒（DKA）的死因，糖尿病的一种常见且致命的急性并发症，是一项具有挑战性的法医任务，因为尸检时缺乏特征性的形态学发现。在这项研究中，傅里叶变换红外（FTIR）微光谱结合化学计量学被用于表征来自不同死因的肺水肿液中的生化差异，以补充传统方法，并提供对 DKA 的有效死后诊断。为此，测量了三种不同情况（DKA 引起的死亡、有糖尿病病史的其他死因引起的死亡和无糖尿病病史的其他死因引起的死亡）下的 FTIR 光谱。主成分分析的结果表明，这三组之间存在不同的光谱特征，主要表现为蛋白质的变化。随后，使用偏最小二乘判别分析（PLS-DA）算法建立了两个二元分类模型，以确定死者是否患有糖尿病以及糖尿病患者是否死于 DKA。PLS-DA 模型的满意预测结果表明这三组之间存在良好的区分。因此，通过对肺水肿液进行 FTIR 微光谱分析，对 DKA 进行死后诊断和检测糖尿病病史是可行的。
