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Retrospective Study
Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Diabetes. Aug 15, 2026; 17(8): 122101
Published online Aug 15, 2026. doi: 10.4239/wjd.122101
Non-antibody biomarkers for differentiating ketosis-onset diabetes: A retrospective study
Si-Qi Pei, Jie-Ling Ren, Li Zhang, Yan-Xia Gao, Xia Yang, Xiang Liu, Su-Ning Li, Ping Liu, Xiao-Yan Xu
Si-Qi Pei, Department of Endocrinology, The First People’s Hospital of Yinchuan, Yinchuan 750000, Ningxia Hui Autonomous Region, China
Jie-Ling Ren, Department of Endocrinology and Rheumatology, 3201 Hospital, General Medical Group, Hanzhong 723000, Shaanxi Province, China
Li Zhang, Yan-Xia Gao, Xia Yang, Xiang Liu, Su-Ning Li, Xiao-Yan Xu, Department of Endocrinology, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
Ping Liu, Department of Endocrinology, Longgang District People’s Hospital of Shenzhen, Shenzhen 518172, Guangdong Province, China
Co-corresponding authors: Ping Liu and Xiao-Yan Xu.
Author contributions: Pei SQ drafted the manuscript; Pei SQ, Ren JL, and Zhang L participated in data collection, analysis, and interpretation; Pei SQ and Liu P contributed to the conception and design of the study; Gao YX, Yang X, Liu X, Li SN, and Xu XY accessed and validated the study data; Liu P and Xu XY contributed equally to this manuscript and are co-corresponding authors. All authors critically revised the manuscript, gave final approval for publication, agreed to be accountable for all aspects of the work and for the decision to submit the manuscript for publication.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript. AI tools were not used to generate original research data, conduct independent analyses, interpret results autonomously, or draw scientific conclusions. All scientific reasoning, methodological decisions, data interpretation, and conclusions were developed and validated exclusively by the authors.
Institutional review board statement: The study was approved by the Ethics Committee of General Hospital of Ningxia Medical University (Approval No. KYLL-2025-2436).
Informed consent statement: The informed consent was waived due to its retrospective design.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Ping Liu, Professor, Department of Endocrinology, Longgang District People’s Hospital of Shenzhen, No. 53 Aixin Road, Yuyuan Community, Longcheng Subdistrict, Shenzhen 518172, Guangdong Province, China. hanner752003@163.com
Received: April 10, 2026
Revised: May 13, 2026
Accepted: July 3, 2026
Published online: August 15, 2026
Processing time: 117 Days and 20.6 Hours
Core Tip

Core Tip: More than one-quarter of adults presenting with ketosis at diabetes onset in our cohort were diagnosed with latent autoimmune diabetes in adults, highlighting the importance of considering autoimmune diabetes in this clinical setting. We identified a panel of readily available non-antibody biomarkers, including 2-hour C-peptide, high-density lipoprotein cholesterol, gamma-glutamyl transferase, homeostasis model assessment of insulin resistance, alkaline phosphatase, free triiodothyronine, and fasting plasma glucose, that demonstrated discriminatory value for differentiating latent autoimmune diabetes in adults from ketosis-prone type 2 diabetes mellitus and for distinguishing ketosis-onset from nonketotic diabetes within the study cohort. These findings may provide supportive information for the clinical evaluation of atypical diabetes when islet autoantibody testing is unavailable; however, independent validation is required before routine clinical application.

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