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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Plasma proteomics identifies four candidate biomarkers associated with macrovascular complications in type 2 diabetes: evidence from a clinical cohort and an animal model

  1. 1Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China
  2. 2Division of Life Sciences and Medicine, University of Science and Technology of China

Abstract

Objective: To identify and validate plasma protein biomarkers for T2DM macrovascular complications through proteomic screening, clinical validation, and animal models.

Methods: Plasma proteomics (4D-DIA, n = 6/group) was used to screen candidate proteins via differential expression, WGCNA, and PPI analyses. Candidates were validated in an independent clinical cohort (n = 162: 41 healthy controls, 35 T2DM alone, 86 T2DM with macrovascular complications) by ELISA for associations with metabolic parameters and diagnostic performance. A diabetic atherosclerosis mouse model (n = 10/group; C57BL/6J for control and diabetic groups, ApoE−/− for diabetic atherosclerosis, 24 weeks) was used to assess protein/mRNA expression and atherosclerotic lesions by Western blot, RT-qPCR, histology, and immunohistochemistry, with correlations to inflammatory and metabolic markers.

Results: In an exploratory proteomic discovery phase using a very small cohort (n = 6 per group), four candidate proteins were prioritized: adenylosuccinate lyase (ADSL), galectin-3 (LGALS3), mannosyl (α-1,3-)-glycoprotein β-1,2-N-acetylglucosaminyltransferase (MGAT1), and V-set and immunoglobulin domain-containing protein 4 (VSIG4). The four-protein panel showed good discrimination (AUC = 0.961). Adding the panel to a clinical model (age, disease duration, and HbA1c) significantly improved diagnostic performance (ΔAUC = 0.138, P = 0.008; NRI = 0.314; IDI = 0.261), with good calibration and internal stability. Firth penalized logistic regression identified ADSL (OR = 0.327, P = 0.0199) and MGAT1 (OR = 7.435, P = 2.71×10 –6 ) as independently associated with prevalent macrovascular disease. In animal models, ADSL, LGALS3, and VSIG4 correlated significantly with seven indicators, while MGAT1 correlated significantly with LDL-C, HDL-C, IL-6, and TNF-α after FDR. LGALS3 and VSIG4, though not independent in multivariable analysis, showed consistent upregulation and moderate discriminative ability (AUC = 0.736 and 0.686), supporting biological relevance.

Conclusion: ADSL and MGAT1 were independently associated with prevalent macrovascular complications.LGALS3 and VSIG4 may reflect cumulative metabolic and inflammatory burden rather than a lack of biological relevance; animal studies provide supportive evidence for this hypothesis.The four-protein panel improved diagnostic discrimination over clinical variables alone. These findings are exploratory and based on a small discovery cohort and internal validation; the four proteins are therefore best regarded as candidate diagnostic biomarkers associated with prevalent disease. Prospective external validation is warranted.

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BibTeX
@article{chen2026plasma,
  title = {{Plasma proteomics identifies four candidate biomarkers associated with macrovascular complications in type 2 diabetes: evidence from a clinical cohort and an animal model}},
  author = {Nuo Chen and Jingxuan Wang and Xiaojing Yuan and Wan Zhou},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1955597},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1955597/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Plasma proteomics identifies four candidate biomarkers associated with macrovascular complications in type 2 diabetes: evidence from a clinical cohort and an animal model
AU  - Nuo Chen
AU  - Jingxuan Wang
AU  - Xiaojing Yuan
AU  - Wan Zhou
PY  - 2026
DA  - 2026/10/30
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1955597
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1955597/full
AB  - Objective: To identify and validate plasma protein biomarkers for T2DM macrovascular complications through proteomic screening, clinical validation, and animal models.  Methods: Plasma proteomics (4D-DIA, n = 6/group) was used to screen candidate proteins via differential expression, WGCNA, and PPI analyses. Candidates were validated in an independent clinical cohort (n = 162: 41 healthy controls, 35 T2DM alone, 86 T2DM with macrovascular complications) by ELISA for associations with metabolic parameters and diagnostic performance. A diabetic atherosclerosis mouse model (n = 10/group; C57BL/6J for control and diabetic groups, ApoE−/− for diabetic atherosclerosis, 24 weeks) was used to assess protein/mRNA expression and atherosclerotic lesions by Western blot, RT-qPCR, histology, and immunohistochemistry, with correlations to inflammatory and metabolic markers.  Results: In an exploratory proteomic discovery phase using a very small cohort (n = 6 per group), four candidate proteins were prioritized: adenylosuccinate lyase (ADSL), galectin-3 (LGALS3), mannosyl (α-1,3-)-glycoprotein β-1,2-N-acetylglucosaminyltransferase (MGAT1), and V-set and immunoglobulin domain-containing protein 4 (VSIG4). The four-protein panel showed good discrimination (AUC = 0.961). Adding the panel to a clinical model (age, disease duration, and HbA1c) significantly improved diagnostic performance (ΔAUC = 0.138, P = 0.008; NRI = 0.314; IDI = 0.261), with good calibration and internal stability. Firth penalized logistic regression identified ADSL (OR = 0.327, P = 0.0199) and MGAT1 (OR = 7.435, P = 2.71×10 –6 ) as independently associated with prevalent macrovascular disease. In animal models, ADSL, LGALS3, and VSIG4 correlated significantly with seven indicators, while MGAT1 correlated significantly with LDL-C, HDL-C, IL-6, and TNF-α after FDR. LGALS3 and VSIG4, though not independent in multivariable analysis, showed consistent upregulation and moderate discriminative ability (AUC = 0.736 and 0.686), supporting biological relevance.  Conclusion: ADSL and MGAT1 were independently associated with prevalent macrovascular complications.LGALS3 and VSIG4 may reflect cumulative metabolic and inflammatory burden rather than a lack of biological relevance; animal studies provide supportive evidence for this hypothesis.The four-protein panel improved diagnostic discrimination over clinical variables alone. These findings are exploratory and based on a small discovery cohort and internal validation; the four proteins are therefore best regarded as candidate diagnostic biomarkers associated with prevalent disease. Prospective external validation is warranted.
SN  - 1664-2392
ER  -