Comparative Analysis of Biomarkers in Type 2 Diabetes Patients with and without Comorbidities: Insights into the Role of Hypertension and Cardiovascular Disease

Abstract

Background: Type 2 diabetes mellitus (T2DM) are 90% of diabetes cases, and its prevalence and incidence, including comorbidities, are rising worldwide. Clinically, diabetes and associated comorbidities are identified by biochemical and physical characteristics including glycaemia, glycated hemoglobin (HbA1c), and tests for cardiovascular, eye and kidney disease. Objectives: Diabetes may have a common etiology based on inflammation and oxidative stress that may provide additional information about disease progression and treatment options. Thus, identifying high-risk individuals can delay or prevent diabetes and its complications. Design: In patients with or without hypertension and cardiovascular disease, as part of progression from no diabetes to T2DM, this research studied the changes in biomarkers between control and prediabetes, prediabetes to T2DM, and control to T2DM, and classified patients based on first-attendance data. Control patients and patients with hypertension, cardiovascular, and with both hypertension and cardiovascular diseases are 156, 148, 61, and 216, respectively. Methods: Linear discriminant analysis is used for classification method and feature importance, This study examined the relationship between Humanin and mitochondrial protein (MOTSc), mitochondrial peptides associated with oxidative stress, diabetes progression, and associated complications. Results: MOTSc, reduced glutathione and glutathione disulfide ratio (GSH/GSSG), interleukin-1beta (IL-1beta), and 8-isoprostane were significant (p<0.05) for the transition from prediabetes to T2DM, highlighting the importance of mitochondrial involvement. Complement component 5a (C5a) is a biomarker associated with disease progression and comorbidities, with GSH/GSSG, monocyte chemoattractant protein-1 (MCP-1), and 8-isoprostane being the most important biomarkers. Conclusions: Comorbidities affect the hypothesized biomarkers as diabetes progresses. Mitochondrial oxidative stress indicators, coagulation, and inflammatory markers help assess diabetes disease development and provide appropriate medications. Future studies will examine longitudinal biomarker evolution.