NMR-based Metabonomics Study Of Patients With Cerebral Infraction Complication In Type 2 Diabetes Mellitus

Objective: Type 2 diabetes mellitus (T2DM) has posed severe damage to global health and it would compromise multiple vital organs of human body. Among variety of complications caused by this disease, cerebrovascular complications has been the major contributor of disability and mortality. This present study aimed to identify the metabolic products with significance through investigating the metabolic products of serum of T2DM patients by applying the method of ¹H-NMR.Methods: Nineteen T2DM patients with cerebral infarction, 25 T2DM patients with atherosclerosis (AS) and 29 healthy controls were included in our study. The micro molecular substances of each participant in serum were investigated by ¹H-NMR. The metabolic profile of each participant was obtained. We performed the PLS-DA to examine the difference of metabolic profile among groups, expecting to find out the metabolic products involved in the development of the cerebral vascular complication of T2DM.Results: Based on the analysis of loading plots of groups, the T2DM patients with cerebral infarction, T2DM patients with AS and the group of healthy controls were clearly distinguished by applying PLS-DA. T2DM patients with AS and healthy controls were also can be identified through the loading plots of their serum. The metabolic products involved in the development of disease included VLDL-C, LDL-C, glucose, 3-Hydroxy-butanoic acid, lactate, pyruvic acid, glycoprotein, taurine, choline, leucine and valine which were commonly found in the diabetes mellitus. Moreover, the level of prostaglandin D₂, E₂, homocysteine and betaine increased in T2DM patients with cerebral infarction. We also found that some metabolic products generated by bacteria living in the alimentary canal, such as TMAO decreased in T2DM patients with AS.Conclusion: The results of our study suggested that the metabolic disorders of lipids, carbohydrate and amino acid were played essential roles in the development of T2DM with PASO and cerebral infarction. The elevated level of prostaglandin D₂, E₂ and homocysteine, taurine, choline may play a role in the occurrence of T2DM with cerebral vascular complication. The change of TMAO and betaine which were caused by enteric dysbacteriosis, also may be contribute to the progress of cerebral vascular complication in T2DM.