Urine metabolomics combined with the personalized diagnosis guided by Chinese medicine reveals subtypes of pre-diabetes

Abstract

The prevalence of type 2 diabetes continuously increases globally. A personalized strategy applied in the pre-diabetic stage is vital for diabetic prevention and management. The personalized diagnosis of Chinese Medicine (CM) may help to stratify the diabetics. Metabolomics is regarded as a potential platform to provide biomarkers for disease-subtypes. We designed an explorative study of 50 pre-diabetic males, combining GC-MS urine metabolomics with CM diagnosis in order to identify diagnostic biomarkers for pre-diabetic subtypes. Three CM physicians reached 85% diagnosis consistency resulting in the classification of 3 pre-diabetic groups. The urine metabolic patterns of groups 1 'Qi-Yin deficiency' and 2 'Qi-Yin deficiency with dampness' (subtype A) and group 3 'Qi-Yin deficiency with stagnation' (subtype B) were clearly discriminated. The majority of metabolites (51%), mainly sugars and amino acids, showed higher urine levels in subtype B compared with subtype A. This indicated more disturbances of carbohydrate metabolism and renal function in subtype B compared with subtype A. No differences were found for hematological and biochemical parameters except for levels of glucose and γ-glutamyltransferase that were significantly higher in subtype B compared with subtype A. This study proved that combining metabolomics with CM diagnosis can reveal metabolic signatures for pre-diabetic subtypes. The identified urinary metabolites may be of special clinical relevance for non-invasive screening for subtypes of pre-diabetes, which could lead to an improvement in personalized interventions for diabetics.

Noninvasive Metabolic Profiling for Painless Diagnosis of Human Diseases and Disorders

“…Wei et al . carried out urinary metabolomic profiling for the identification of metabolites relevant for noninvasive diagnosis and stratification of prediabetic stage, which might be imperative in customized treatment for diabetics [38]. Although determination of phenylalanine/tyrosine ratio in blood has been conventionally utilized in diagnosis of phenylketonuria, there are limitations presented by its invasive nature and associated false positives.…”

Holistic and dynamic metabolic alterations of traditional Chinese medicine syndrome in a toxic heat and blood stasis syndrome rat model

“…Prior to each experiment, the rats were fasted for 12 h with free drinking. Among them, 48 rats were used for evaluation of the THBSS stage and randomly divided into 6 groups named the 2 h control group (2 h CG), 2 h THBSS group (2 h TG), 8 …”

“…Recently, TCM syndromes were detected and veried in some diseases under Western medicine's demarcation, including postmenopausal osteoporosis, 4 gastric mucosal dysplasia, 5 coronary heart disease, 6 etc. Meanwhile, TCM syndromes were applied for the classication and diagnosis of some complicated diseases, such as rheumatoid arthritis, 7 diabetes, 8 etc. Accordingly, elucidating the modern connotation of TCM syndromes will benet the objectication of TCM diagnosis and treatment, and also promote the application of integrated TCM and Western medicine in the treatment of complex diseases.…”

Introduction of two novel devices for investigating the influence of non-mechanical components such as therapeutic qi in acupuncture

“…Traditional Chinese medicine (TCM) diagnosis, TCM pattern [1][2][3] Meridians [4][5][6] Acupuncture points [1,4,6,7] Needle insertion (except for laser acupuncture) [8,9] Needle stimulation (mechanical or electrical or laser) [1,[10][11][12] De qi (perceived by patient) [1,[13][14][15][16] Needle grasp (perceived by acupuncturist) [10] Number of needles [17] Needle retention time [1,14] Non-specific for acupuncture Patient's expectations or belief [14,18,19] Acupuncturist's expectations or belief [18,20] Acupuncturist's intention [21] Communication [22][23][24] Therapeutic relationship [22] Acupuncturist's skills and experience [1,23] Cultural background [25] Number or frequency of treatments [1] Placebo effects [26,27] Journal of Integrative Medicine intensively moving the needle handle, the movement of the needle on the inside of the Veliusator was monitored by the sensor.…”

“…Very recently it has been discovered by metabolomics that some patterns described in TCM have a correlate in biomedicine [2,3] . Meridians and acupuncture points are proposed to exert effects and properties beyond the immediate surrounding tissue.…”