Untargeted LC-MS/MS profiling identifies metabolite networks associated with glycemic dysregulation in diabetes cohorts.

This cohort study utilized untargeted liquid chromatography-mass spectrometry (LC-MS/MS) profiling and weighted coexpression network analysis to investigate metabolic changes. The population included people with normal glucose tolerance, prediabetes, and type 2 diabetes. Samples were collected at baseline and 2 hours after an oral glucose tolerance test to assess dynamic metabolic responses across the groups involved in the study.

Researchers profiled 15,470 serum metabolite features across the study groups. Coregulated modules were strongly associated with glycemic dysregulation, insulin resistance, and islet dysfunction. Short-chain organic acids, particularly crotonic acid, emerged as hubs of diabetes-associated networks, accumulating progressively with disease severity.

Regarding circulating proteins, 16.5% were crotonylated. Approximately 40% of these correlated with crotonic acid and other hub metabolites. These associations currently suggest a potential metabolome-crotonylome axis, though the observational nature of the data limits causal inference regarding disease development mechanisms.

Key limitations include that metabolic networks underlying disease development remain poorly understood. There were no reported adverse events or safety concerns specific to the profiling method. Practice relevance is currently limited pending further investigation into the clinical implications of these metabolite networks for patient management and therapeutic targets. Clinicians should interpret these findings as hypothesis-generating rather than definitive guidance for treatment protocols at this time.