Potential mechanism associated with post-heart transplantation diabetes mellitus in Chinese patients.

Abstract

Background: Post-transplantation diabetes mellitus (PTDM) is a common metabolic complication following heart transplantation, which not only leads to elevated microvascular morbidity, but also seriously affects graft function and recipient survival. However, the specific metabolites and underlying mechanisms are not yet fully understood.

Methods: A total of 106 adult heart transplant recipients (56 PTDM and 50 non-PTDM) who followed for more than one year were enrolled in the study. The untargeted metabolomics was performed by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The demographic, clinical data and drug information were collected at the time of sample collection.

Results: PTDM patients were older (p=0.003), with higher BMI (p=0.010), higher triglyceride levels (TG, p=0.007), and a higher prevalence of hypertension (p=0.001) than non-PTDM. A total of 1174 metabolites were detected, of which 99 metabolites showed significantly differentially abundant (VIP>1, p<0.05, FC>1.5 or <0.67). KEGG functional enrichment analysis showed these differently expressed metabolites could be further enriched in ABC transporter, carbon metabolism, retrograde endocannabinoid signaling, phospholipase D signaling pathway. Compared with non-PTDM group, glutamate, diacylglycerol (DAG) and D-sorbitol were significantly changed in PTDM through metabolomics.

Conclusions: These findings may provide a novel understanding of the pathological mechanism of PTDM and could be utilized to predict the development and progression of PTDM.