| BACKGROUND: Diabetes mellitus(DM)is one of the most common chronic diseases and its complications are a serious health problem.Erectile dysfunction(ED),as one of the complications of diabetic disease,has a profound impact on quality of life,yet is often overlooked.Currently,the main diagnostic methods for diabetic erectile dysfunction(DED)are the International Index of Erectile Function(IIEF-5)questionnaire,Penile doppler ultrasonography,cavernous angiography and Nocturnal erection and hardness monitoring(NPTRT).The application of Rigiscan in NPTR is considered to be a powerful tool to differentiate psychogenic ED from organic ED,but it is difficult to obtain data due to its high cost,long duration,insufficient number of subjects and poor compliance.At this stage,data on serum biomarkers in diabetic ED patients are relatively limited,and lipidomics,as an important branch of metabolomics,can efficiently study the alterations and functions of lipid families and lipid molecules in various biological processes,and then identify key lipid markers in metabolic regulation and elucidate the related biological activity processes and mechanisms.OBJECTIVE: The aim of this study was to systematically evaluate diabetic erectile dysfunction and to screen for specific serum markers of early onset of diabetic erectile dysfunction based on lipidomics to detect changes in serum lipid composition in diabetic patients with combined ED and diabetic patients without combined ED,thus helping to diagnose diabetic erectile dysfunction early.METHODS: Patients with type 2 DM combined with ED(DM-ED group,n=14)and patients with type 2 DM without combined ED(DM group,n=13)who visited the Department of Endocrinology and Metabolism of Changzhou Second People’s Hospital from March 2021 to July 2022 were included as study subjects.All study subjects underwent data collection,including age,previous disease history,body mass index,blood pressure,white blood cells,hemoglobin,platelets,alanine aminotransferase,aspartate aminotransferase,glutamyl transferase,total bilirubin,urea nitrogen,blood creatinine,uric acid,triglycerides,cholesterol,high-density lipoprotein,low-density lipoprotein,lipoprotein A,urine microalbumin,urine creatinine,glycated hemoglobin,Cpeptide,thyroid stimulating hormone,free triiodothyronine,free tetraiodothyronine,Estradiol,testosterone,progesterone,prolactin,luteinizing hormone,follicle stimulating hormone,etc.,and Rigiscan assay.Ultra performance liquid chromatography-tandem mass spectrometry was applied for qualitative and quantitative detection of serum lipidomic metabolites in all study subjects,and univariate,multivariate and subject operating characteristic(ROC)analyses were applied to screen out significantly different lipid molecules.RESULTS: Peripheral serum lipid profiles detected six major lipid classes: fatty acids,glycerolipids,glycerophospholipids,sphingolipids,sterols,and pregnenolone lipids,including 44 subclasses and 2669 lipid molecules.By univariate analysis,36 lipid molecules were found to be down-regulated(FC<0.67,P-value<0.05)and 71 lipid molecules were up-regulated(FC>1.5,P-value<0.05)in the DM-ED group compared to the DM group.Multivariate analysis studies showed that 23 lipid molecules were significantly different between the two groups,of which 8 TG(18:0＿20:1＿22:4),PC(38:6),PI(18:0＿20:4),CL(74:1),ST(t16:0＿20:2),PE(18:1＿20:4),CL(78:9),LPC(20:4)Lipid molecule AUC values were >0.7(FC>1.5 or FC<0.67,VIP>1,P-value<0.05).CONCLUSION: Serum lipid profiles of type 2 diabetic patients with combined ED were significantly different compared with those of type 2 diabetic patients without combined ED,with TG(18:0＿20:1＿22:4),PC(38:6),PI(18:0＿20:4),CL(74:1),ST(t16:0＿20:2),PE(18:1＿20:4),CL(78:9),LPC(20:4)AUC values were >0.7,which may become potential biomarkers for diagnosing DED and monitoring disease progression. |
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