Liquid Biopsy Can Detect Diabetes Complications

A liquid biopsy technique can detect patients at risk for diabetic complications such as macrovascular and microvascular events, according to a study published in Clinical Chemistry.

The study included 62 Chinese patients with diabetes: 12 had no vascular complications, 34 had a singular vascular complication, and 16 had multiple vascular complications. Patients were treated with insulin (n=36), oral glucose-lowering medications (n=34), antihypertensive medications (n=25), or cholesterol-lowering medications (n=7). The mean patient age was 59 years (range, 34-86 years) and 61.3% (n=38) were male.

Researchers used a chemical labeling strategy for 5-hydroxymethylcytosines (5hmC-Seal) to profile genome-wide 5hmCs, which are epigenetic markers that indicate diseases like diabetes. They assessed modified 5hmC markers in a case-control design. The test uses just 3 to 5 mL of blood.

Patients were randomized to a training (n=31) and testing (n=31) set. A 16-gene panel of 5hmC markers was identified for differentiating patients with and without complications (area under the curve [AUC] = 0.85; 95% confidence interval [CI], 0.73-0.96); this test outperformed conventional clinical variables such as urinary albumin. In both cohorts, patients without diabetes complications had significantly lower scores than those with complications.

Statistically significant changes in 5hmC markers were associated with type 2 diabetes-related macrovascular and microvascular complications, involving genes and pathways relevant to vascular biology and diabetes, including insulin resistance and inflammation.

In addition, a separate 13-gene 5hmC marker panel distinguished patients with single complications from those with multiple complications (AUC=0.84; 95% CI, 0.68–0.99), also demonstrating superiority over conventional clinical variables.

“The 5hmC-Seal assay has the potential to be a clinically convenient, non-invasive approach that can be applied in the clinic to monitor the presence and severity of diabetic vascular complications,” the researchers concluded. Read more