Early Detection of Pancreatic Cancer in Type 2 Diabetes Mellitus Patients Based on ¹H NMR Metabolomics

Abstract

The association of pancreatic cancer with type 2 diabetes mellitus was investigated by 1H NMR metabolomic analysis of blood plasma. Concentration data of 58 metabolites enabled discrimination of pancreatic cancer (PC) patients from healthy controls (HC) and long-term type 2 diabetes mellitus (T2DM) patients. A panel of eight metabolites was proposed and successfully tested for group discrimination. Furthermore, a prediction model for the identification of at-risk individuals for future development of pancreatic cancer was built and tested on recent-onset diabetes mellitus (RODM) patients. Six of 59 RODM samples were assessed as PC with an accuracy of more than 80%. The health condition of these individuals was re-examined, and in four cases, a correlation to the prediction was found. The current health condition can be retrospectively attributed to misdiagnosed pancreatogenic diabetes or to early-stage pancreatic cancer.

Potential Metabolite Biomarkers for Early Detection of Stage-I Pancreatic Ductal Adenocarcinoma

“…Proline is one of the nonessential amino acids, which has been shown that it can be used as the main carbon source by pancreatic cancer to maintain mitochondrial function and the TCA cycle ( 30 , 31 ). A decrease of proline level in PDAC has been reported in several studies, which may indicate the vigorous metabolism of pancreatic cancer cells ( 27 , 32 , 33 ).…”

“…Michálková et al. ( 27 ) used 1 H NMR metabolomic analysis to discriminate PDAC patients from healthy controls and also from T2DM by plasma samples. Isoleucine was found increased in T2DM, but without statistical significance.…”

Diabetes and pancreatic cancer: Exploring the two-way traffic

“…Out of them, two metabolites namely N-Succinyl-L-diaminopimelic-acid and PE (18: 2) had shown good sensitivity (93.3%) and specificity (93.1%) for PC in the logistic regression analysis. A recent nuclear magnetic resonance based study also identified a panel of eight metabolites with good accuracy (more than 80%) in the discrimination of PC and long-standing T2DM patients[ 112 ]. In future, possibly a panel of metabolites will help us to improve the precision medicine in identifying the cases requiring close follow-up for detection of PC among diabetes patients.…”

Serum Metabolomic and Lipoprotein Profiling of Pancreatic Ductal Adenocarcinoma Patients of African Ancestry

“…In this sense, Nuclear Magnetic Resonance (NMR) spectroscopy was shown to be a powerful technique for the high-throughput analysis of blood samples [19,20]. NMR spectroscopy has been used to investigate the serum metabolome of patients with PDAC to distinguish malignant and benign diseased states and some metabolites, such as leucine, valine, isoleucine, tyrosine, lysine, creatinine, triglycerides, and 3-hydroxybutyrate, were dysregulated [21][22][23][24]. Although these authors reported the blood-based metabolomics biomarkers of PDAC, their findings did not make associations to outcomes and were conducted in other population groups [25,26].…”