Identification of the biomarkers of ACS co-morbid T2DM in human serum through UHPLC/MS study

Type 2 diabetes mellitus (T2DM) is closely associated with an increased risk and adverse event of acute coronary syndrome (ACS). The present study aims to identify metabolic biomarker, and discuss the association between metabolic phenotype and clinical phenotype in ACS co-morbid T2DM patients. Serum metabolic study was conducted in ACS co-morbid T2DM patients by using ultra-high performance liquid chromatography-mass spectrometry (UHPLC/MS). Association between the differential metabolites and serum fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), Syntax score I and major adverse cardiovascular event (MACE) were analyzed using Spearman's correlation. COX regression and Kaplan-Meier survival curve were employed to recognize the risk factors of MACE, time-dependent receptor operating characteristic (ROC) curve was used to assess the predictive value of the risk factors.The Kyoto Encyclopedia of Genes and Genomes (KEGG) database was applied for metabolic pathway identification. We found that serum 7-Ketocholesterol, L-Dopa and 2-furanacrolein are potential biomarkers of ACS co-morbid T2DM. These three biomarkers synergize to demonstrate high predictive value (AUC = 0.953) for the occurrence of MACE. This implies that in ACS co-morbid T2DM patients, there is a close correlation between the metabolic phenotype and the clinical phenotype.