Plasma protein N-glycosylation is associated with cardiovascular disease, nephropathy, and retinopathy in type 2 diabetes

Elham Memarian, Leen M. T' Hart, Roderick C. Slieker, Roosmarijn F.L. Lemmers, Amber A. Van Der Heijden, Femke Rutters, Giel Nijpels, Emma Schoep, Aloysius G. Lieverse, Eric J.G. Sijbrands, Manfred Wuhrer, Mandy Van Hoek*, Viktoria Dotz

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Introduction Although associations of total plasma N-glycome (TPNG) with type 2 diabetes have been reported, little is known on the role of TPNG in type 2 diabetes complications, a major cause of type 2 diabetes-related morbidity and mortality. Here, we assessed TPNG in relation to type 2 diabetes complications in subsamples of two Dutch cohorts using mass spectrometry (n=1815 in DiaGene and n=1518 in Hoorn Diabetes Care System).

Research design and methods Blood plasma samples and technical replicates were pipetted into 96-well plates in a randomized manner. Peptide:N-glycosidase F (PNGase F) was used to release N-glycans, whereafter sialic acids were derivatized for stabilization and linkage differentiation. After total area normalization, 68 individual glycan compositions were quantified in total and were used to calculate 45 derived traits which reflect structural features of glycosylation. Associations of glycan features with prevalent and incident microvascular or macrovascular complications were tested in logistic and Cox regression in both independent cohorts and the results were meta-analyzed.

Results Our results demonstrated similarities between incident and prevalent complications. The strongest association for prevalent cardiovascular disease was a high level of bisection on a group of diantennary glycans (A2FS0B; OR=1.38, p=1.34×10−11), while for prevalent nephropathy the increase in 2,6-sialylation on triantennary glycans was most pronounced (A3E; OR=1.28, p=9.70×10−6). Several other TPNG features, including fucosylation, galactosylation, and sialylation, firmly demonstrated associations with prevalent and incident complications of type 2 diabetes.

Conclusions These findings may provide a glance on how TPNG patterns change before complications emerge, paving the way for future studies on prediction biomarkers and potentially disease mechanisms.
Original languageEnglish
Article numbere002345
Number of pages9
JournalBMJ Open Diabetes Research and Care
Issue number1
Publication statusPublished - 13 Oct 2021

Bibliographical note

EM was supported by funding from the European Union’s Horizon 2020
research and innovation program under the Marie Sklodowska-Curie grant for
the project GlySign (contract no. 722095). MvH was supported by the ErasmusMC


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