Diabetes, Metabolic Syndrome and Obesity (Oct 2023)

Formate Might Be a Novel Potential Serum Metabolic Biomarker for Type 2 Diabetic Peripheral Neuropathy

  • Xu W,
  • Xue W,
  • Zhou Z,
  • Wang J,
  • Qi H,
  • Sun S,
  • Jin T,
  • Yao P,
  • Zhao JY,
  • Lin F

Journal volume & issue
Vol. Volume 16
pp. 3147 – 3160

Abstract

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Weisheng Xu,1,2,* Wangsheng Xue,1,* Zeyu Zhou,3,* Jiying Wang,1 Hui Qi,1 Shiyu Sun,1 Tong Jin,1 Ping Yao,1 Jian-Yuan Zhao,4 Fuqing Lin1 1Department of Pain Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China; 2School of Medicine, Tongji University, Shanghai, 200331, People’s Republic of China; 3School of Life Sciences, Fudan University, Shanghai, 200433, People’s Republic of China; 4Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200090, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fuqing Lin, Department of Pain Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China, Email [email protected] Jian-Yuan Zhao, Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200090, People’s Republic of China, Email [email protected]: As one of the most frequent complications of type 2 diabetes mellitus (T2DM), diabetic peripheral neuropathy (DPN) shows a profound impact on 50% of patients with symptoms of neuropathic pain, numbness and other paresthesia. No valid serum biomarkers for the prediction of DPN have been identified in the clinic so far. This study is to investigate the potential serum biomarkers for DPN firstly based on 1H-Nuclear Magnetic Resonance (1H-NMR)-based metabolomics technique.Methods: Thirty-six patients enrolled in this study were divided into two groups: 18 T2DM patients without DPN (T2DM group) and 18 T2DM patients with DPN (DPN group). Serum metabolites were measured via 1H-NMR spectroscopy. Bioinformatic approaches including principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), independent sample t-test, Fisher’s test, Pearson and Spearman correlation analysis, Stepwise multiple linear regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify the potential altered serum biomarkers.Results: A total of 20 metabolites were obtained and further analyzed. Formate was identified as the only potential biomarker that decreased in the DPN group with statistical significance after multiple comparisons (p< 0.05). Formate also displayed a negative relationship with some elevated clinical markers in DPN. ROC curve analysis showed a good discriminative ability for formate in DPN with an area under the curve (AUC) value of 0.981.Conclusion: Formate could be considered a potential serum metabolic biomarker for DPN. The reduced level of formate in DPN may be associated with mitochondrial dysfunction and gut microbiota alteration. Monitoring the level of serum formate would be an important strategy for the early diagnosis of DPN and a supplement of formate may be a promising treatment for DPN in the future.Keywords: diabetic peripheral neuropathy, type 2 diabetes mellitus, 1H-NMR, metabolomics, formate, uric acid

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