Serum metabolomic analysis revealed potential metabolite biomarkers for diabetes mellitus with coronary heart disease.

Diabetes, including its predominant form, type 2 diabetes mellitus (T2DM), has a distinctive correlation with coronary heart disease (CHD). Patients with diabetes have shown statistically higher potential risk of developing CHD complications than those without diabetes. In this study, we have conducted a metabolomic analysis of serum samples from healthy controls as well as patients with T2DM or both T2DM and CHD (CHD-T2DM). Statistical analysis of the metabolomic data revealed 611 and 420 significantly altered metabolic signatures in T2DM and CHD-T2DM patients, respectively, when compared to the healthy controls. Meanwhile, 653 metabolic features were significantly different between the CHD-T2DM and T2DM groups. Some of the metabolites at significantly different levels were identified and may serve as potential biomarkers for T2DM or CHD-T2DM. We selected three candidates, phosphocreatine (PCr), cyclic guanosine monophosphate (cGMP) and taurine for further validation among independent T2DM, CHD-T2DM and healthy control populations. These three metabolites were found to be significantly elevated in the CHD-T2DM group when compared to both T2DM and healthy control groups by the metabolomic analysis. Our results indicated that both PCr and cGMP but not taurine were successfully validated and may serve as predictive biomarkers of CHD in patients with T2DM.