Nature Communications (May 2023)

Identification of biomarkers for glycaemic deterioration in type 2 diabetes

  • Roderick C. Slieker,
  • Louise A. Donnelly,
  • Elina Akalestou,
  • Livia Lopez-Noriega,
  • Rana Melhem,
  • Ayşim Güneş,
  • Frederic Abou Azar,
  • Alexander Efanov,
  • Eleni Georgiadou,
  • Hermine Muniangi-Muhitu,
  • Mahsa Sheikh,
  • Giuseppe N. Giordano,
  • Mikael Åkerlund,
  • Emma Ahlqvist,
  • Ashfaq Ali,
  • Karina Banasik,
  • Søren Brunak,
  • Marko Barovic,
  • Gerard A. Bouland,
  • Frédéric Burdet,
  • Mickaël Canouil,
  • Iulian Dragan,
  • Petra J. M. Elders,
  • Celine Fernandez,
  • Andreas Festa,
  • Hugo Fitipaldi,
  • Phillippe Froguel,
  • Valborg Gudmundsdottir,
  • Vilmundur Gudnason,
  • Mathias J. Gerl,
  • Amber A. van der Heijden,
  • Lori L. Jennings,
  • Michael K. Hansen,
  • Min Kim,
  • Isabelle Leclerc,
  • Christian Klose,
  • Dmitry Kuznetsov,
  • Dina Mansour Aly,
  • Florence Mehl,
  • Diana Marek,
  • Olle Melander,
  • Anne Niknejad,
  • Filip Ottosson,
  • Imre Pavo,
  • Kevin Duffin,
  • Samreen K. Syed,
  • Janice L. Shaw,
  • Over Cabrera,
  • Timothy J. Pullen,
  • Kai Simons,
  • Michele Solimena,
  • Tommi Suvitaival,
  • Asger Wretlind,
  • Peter Rossing,
  • Valeriya Lyssenko,
  • Cristina Legido Quigley,
  • Leif Groop,
  • Bernard Thorens,
  • Paul W. Franks,
  • Gareth E. Lim,
  • Jennifer Estall,
  • Mark Ibberson,
  • Joline W. J. Beulens,
  • Leen M ’t Hart,
  • Ewan R. Pearson,
  • Guy A. Rutter

DOI
https://doi.org/10.1038/s41467-023-38148-7
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 18

Abstract

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Abstract We identify biomarkers for disease progression in three type 2 diabetes cohorts encompassing 2,973 individuals across three molecular classes, metabolites, lipids and proteins. Homocitrulline, isoleucine and 2-aminoadipic acid, eight triacylglycerol species, and lowered sphingomyelin 42:2;2 levels are predictive of faster progression towards insulin requirement. Of ~1,300 proteins examined in two cohorts, levels of GDF15/MIC-1, IL-18Ra, CRELD1, NogoR, FAS, and ENPP7 are associated with faster progression, whilst SMAC/DIABLO, SPOCK1 and HEMK2 predict lower progression rates. In an external replication, proteins and lipids are associated with diabetes incidence and prevalence. NogoR/RTN4R injection improved glucose tolerance in high fat-fed male mice but impaired it in male db/db mice. High NogoR levels led to islet cell apoptosis, and IL-18R antagonised inflammatory IL-18 signalling towards nuclear factor kappa-B in vitro. This comprehensive, multi-disciplinary approach thus identifies biomarkers with potential prognostic utility, provides evidence for possible disease mechanisms, and identifies potential therapeutic avenues to slow diabetes progression.