Novel Biomarkers to Distinguish between Type 3c and Type 2 Diabetes Mellitus by Untargeted Metabolomics

Abstract

Pancreatogenic diabetes mellitus (T3cDM) is a highly frequent complication of pancreatic disease, especially chronic pancreatitis, and it is often misdiagnosed as type 2 diabetes mellitus (T2DM). A correct diagnosis allows the appropriate treatment of these patients, improving their quality of life, and various technologies have been employed over recent years to search for specific biomarkers of each disease. The main aim of this metabolomic project was to find differential metabolites between T3cDM and T2DM. Reverse-phase liquid chromatography coupled to high-resolution mass spectrometry was performed in serum samples from patients with T3cDM and T2DM. Multivariate Principal Component and Partial Least Squares-Discriminant analyses were employed to evaluate between-group variations. Univariate and multivariate analyses were used to identify potential candidates and the area under the receiver-operating characteristic (ROC) curve was calculated to evaluate their diagnostic value. A panel of five differential metabolites obtained an area under the ROC curve of 0.946. In this study, we demonstrate the usefulness of untargeted metabolomics for the differential diagnosis between T3cDM and T2DM and propose a panel of five metabolites that appear altered in the comparison between patients with these diseases.

Diabetes of the Exocrine Pancreas: Implications for Pharmacological Management

“…At the same time, fasting insulin and homeostatis model assessment of insulin resistance (HOMA-IR) were not associated with any marker of lipid metabolism in this population, suggesting that insulin resistance is not a major driver of dyslipidemia in PPDM [ 91 ]. A 2020 metabolomics study sought biomarkers in serum that distinguish DEP from type 2 diabetes [ 93 ]. Notably, of the 5 identified biomarkers, 4 belonged to lipids.…”

Glucagon-like peptide 1 receptor agonists in the treatment of type II diabetes

“…It is interesting that diabetes associated with pancreatic ductal adenocarcinoma is often pancreatogenic diabetes mellitus (T3cDM) [19]. In the past, T3cDM was often misdiagnosed as T2D, but it is important to recognize the difference between T3cDM and T2D in order to provide a better treatment [20]. Researchers found that using untargeted metabolomics torecognize T3cDM and T2D is workable [20].…”

“…In the past, T3cDM was often misdiagnosed as T2D, but it is important to recognize the difference between T3cDM and T2D in order to provide a better treatment [20]. Researchers found that using untargeted metabolomics torecognize T3cDM and T2D is workable [20].…”

Chronic Pancreatitis and Diabetes of Exocrine Pancreas / Type 3c Diabetes Mellitus / Post-pancreatitis Diabetes Mellitus

“…In general, the diagnosis is based on the presence of exocrine pancreatic insufficiency, supported by the determination of the values of liposoluble vitamins, especially vitamin D, and evidence of persistent pancreatic abnormalities, using imaging methods. However, the condition is the absence of autoimmune markers that are associated with type 1 DM [41]. Currently, attention is paid to the determination of some metabolites that are different between type 2 DM and T3cDM.…”