Department of Clinical Laboratory, Yixing People's Hospital, Yixing, China.
Department of Endocrinology, Yixing People's Hospital, Yixing, China.
Lab Med. 2024 Nov 4;55(6):724-731. doi: 10.1093/labmed/lmae039.
Type 2 diabetes mellitus (T2DM) intricately involves disrupted lipid metabolism. Exosomes emerge as carriers of biomarkers for early diagnosis and monitoring. This study aims to identify lipid metabolites in serum exosomes for T2DM diagnosis.
Serum samples were collected from newly diagnosed T2DM patients and age and body mass index-matched healthy controls. Exosomes were isolated using exosome isolation reagent, and untargeted/targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to identify and validate altered lipid metabolites. Receiver operating characteristic curve analysis was used to evaluate the diagnostic value of candidate lipid metabolites.
Serum exosomes were successfully isolated from both groups, with untargeted LC-MS/MS revealing distinct lipid metabolite alterations. Notably, phosphatidylethanolamine (PE) (22:2(13Z,16Z)/14:0) showed stable elevation in T2DM-serum exosomes. Targeted LC-MS/MS confirmed significant increase of PE (22:2(13Z,16Z)/14:0) in T2DM exosomes but not in serum. PE (22:2(13Z,16Z)/14:0) levels not only positively correlated with hemoglobin A1C levels and blood glucose levels, but also effectively distinguished T2DM patients from healthy individuals (area under the curve = 0.9141).
Our research sheds light on the importance of serum exosome lipid metabolites in diagnosing T2DM, providing valuable insights into the complex lipid metabolism of diabetes.
2 型糖尿病(T2DM)复杂地涉及到脂质代谢紊乱。外泌体作为生物标志物的载体,可用于早期诊断和监测。本研究旨在鉴定血清外泌体中的脂质代谢物,用于 T2DM 的诊断。
收集新诊断的 T2DM 患者和年龄、体重指数匹配的健康对照者的血清样本。使用外泌体分离试剂分离血清外泌体,采用非靶向/靶向液相色谱-串联质谱(LC-MS/MS)鉴定和验证改变的脂质代谢物。采用受试者工作特征曲线分析评估候选脂质代谢物的诊断价值。
成功从两组中分离出血清外泌体,非靶向 LC-MS/MS 显示出明显的脂质代谢物改变。值得注意的是,PE(22:2(13Z,16Z)/14:0)在 T2DM 血清外泌体中稳定升高。靶向 LC-MS/MS 证实 T2DM 外泌体中 PE(22:2(13Z,16Z)/14:0)显著增加,但血清中没有增加。PE(22:2(13Z,16Z)/14:0)水平不仅与糖化血红蛋白水平和血糖水平呈正相关,而且能够有效区分 T2DM 患者和健康个体(曲线下面积=0.9141)。
本研究揭示了血清外泌体脂质代谢物在诊断 T2DM 中的重要性,为糖尿病复杂的脂质代谢提供了有价值的见解。