Abstract

Diabetes mellitus, a disease of modern civilization, is considered the major mainstay of mortalities around the globe. A great number of biochemical changes have been proposed to occur at metabolic levels between perturbed glucose, amino acid, and lipid metabolism to finally diagnoe diabetes mellitus. This window period, which varies from person to person, provides us with a unique opportunity for early detection, delaying, deferral and even prevention of diabetes. The early detection of hyperglycemia and dyslipidemia is based upon the detection and identification of biomarkers originating from perturbed glucose, amino acid, and lipid metabolism. The emerging “OMICS” technologies, such as metabolomics coupled with statistical and bioinformatics tools, proved to be quite useful to study changes in physiological and biochemical processes at the metabolic level prior to an eventual diagnosis of DM. Approximately 300–400 such metabolites have been reported in the literature and are considered as predicting or risk factor-reporting metabolic biomarkers for this metabolic disorder. Most of these metabolites belong to major classes of lipids, amino acids and glucose. Therefore, this review represents a snapshot of these perturbed plasma/serum/urinary metabolic biomarkers showing a significant correlation with the future onset of diabetes and providing a foundation for novel early diagnosis and monitoring the progress of metabolic syndrome at early symptomatic stages. As most metabolites also find their origin from gut microflora, metabolism and composition of gut microflora also vary between healthy and diabetic persons, so we also summarize the early changes in the gut microbiome which can be used for the early diagnosis of diabetes.

Highlights

  • Diabetes mellitus (DM) is the most prevalent modern civilization disease and 8th major mainstay of mortalities globally

  • In PL, 3 ceramides, 2 lactosylceramides, and 1 dihydroceramide showed a constructive relation with HOMA-IR and fasting insulin levels whilst six-lipid species showed a negative correlation with the insulin sensitivity suggesting these metabolites as early biomarkers of-diabetes owing to HFD consumption

  • Several perturbed metabolic biomarkers have been proposed for early prediction of metabolic syndrome

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Summary

Introduction

Diabetes mellitus (DM) is the most prevalent modern civilization disease and 8th major mainstay of mortalities globally. Non-glucose/insulin related reliable and validated biomarkers are needed to complement our knowledge on diabetes development and indicate prognostic biomarkers It has been reported in the literature that metabolic syndrome (pre-diabetic/diabetic state) is likely to alter the metabolic pathways related to sugars, lipids, amino acids and their resulting metabolites resulting in the perturbed respective metabolites level in predisposed individuals compared to healthy ones [4]. Literature is full of many prospective, randomized, blinded, nested and case-controlled cohort studies where the populations of different geographical localities have been recruited and tested for decades to comprehensively understand the prognosis of DM in both vulnerable and non-vulnerable subjects These studies came up with a wide range of early T2DM biomarkers, especially of sugars, lipids and amino acids origin. It is highly probable that a growing number of these novel T2DM biomarkers can be translated into clinical applications that will upgrade the current medical routine in regards to personalized medicine

Biomarkers of Disturbed Protein Metabolism
Biomarkers of Disturbed Lipid Metabolism
Biomarkers of Disturbed Microbiome and Microbiome-Related Metabolites
Findings
Conclusions
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