Urinary biomarkers for diagnosing poststroke depression in patients with type 2 diabetes mellitus

Abstract

Background

Depression can seriously affect the quality of life of type 2 diabetes mellitus (T2DM) patients after stroke. However, there were still no objective methods to diagnose T2DM patients with poststroke depression (PSD). Therefore, we conducted this study to deal with this problem.

Methods

Gas chromatography-mass spectroscopy (GC-MS)-based metabolomics profiling method was used to profile the urinary metabolites from 83 nondepressed T2DM patients after stroke and 101 T2DM patients with PSD. The orthogonal partial least-squares discriminant analysis was conducted to explore the metabolic differences in T2DM patients with PSD. The logistic regression analysis was performed to identify the optimal and simplified biomarker panel for diagnosing T2DM patients with PSD. The receiver operating characteristic curve analysis was used to assess the diagnostic performance of this biomarker panel.

Results

In total, 23 differential metabolites (7 decreased and 16 increased in T2DM patients with PSD) were found. A panel consisting of pseudouridine, malic acid, hypoxanthine, 3,4-dihydroxybutyric acid, fructose and inositol was identified. This panel could effectively separate T2DM patients with PSD from nondepressed T2DM patients after stroke. The area under the curve was 0.965 in the training set and 0.909 in the validation set. Meanwhile, we found that the galactose metabolism was significantly affected in T2DM patients with PSD.

Conclusion

Our results could be helpful for future development of an objective method to diagnose T2DM patients with PSD and provide novel ideas to study the pathogenesis of depression.

Keywords:

• type 2 diabetes mellitus
• post-stroke depression
• metabolite
• metabolomics

Acknowledgment

This project is funded by the Health Family Planning Research Program of Inner Mongolia Autonomous Region (Grant No. 201703005), the Natural Science Foundation of Inner Mongolia Autonomous Region of China (Grant No. 2016MS0884), and the Foundation Project of the Inner Mongolia Autonomous Region People’s Hospital (Grant No. 201551).

Disclosure

The authors declare no financial or other conflicts of interest in this work.