Plasma metabolomics reveals progressive alterations across glycemic states

doi:10.4239/wjd.122419

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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. Sep 15, 2026; 17(9): 122419
Published online Sep 15, 2026. doi: 10.4239/wjd.122419

Plasma metabolomics reveals progressive alterations across glycemic states

Yun-Tong Liu, Li-Ping Yu, Dong-Li Zhu, Zhen-Ping Li, Jin-Ping Zhang, Ling-Ding Xie, Lu-Lu Song, Yi-Fan He, Xian Jin, Zhao-Qing Li, Rui-Fen Deng, Cong Zhang, Bo Zhang

Yun-Tong Liu, Li-Ping Yu, Jin-Ping Zhang, Ling-Ding Xie, Lu-Lu Song, Yi-Fan He, Xian Jin, Zhao-Qing Li, Rui-Fen Deng, Cong Zhang, Bo Zhang, Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China

Yun-Tong Liu, Department of Endocrinology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Dong-Li Zhu, Zhen-Ping Li, Department of Endocrinology, Daqing Oilfield General Hospital, Daqing 163001, Heilongjiang Province, China

Co-first authors: Yun-Tong Liu and Li-Ping Yu.

Author contributions: Liu YT and Yu LP wrote the original draft, visualized the data, contributed equally to this work as co-first authors; Liu YT, Yu LP, and Zhang JP contributed to methodology; Liu YT, Yu LP, Zhang JP, Xie LD, Song LL, He YF, Jin X, Li ZQ, Deng RF, and Zhang C performed the investigation; Liu YT, Yu LP, and Li ZQ performed the formal analysis; Liu YT, Yu LP, and Deng RF curated the data; Liu YT, Yu LP, Zhang C, and Zhang B reviewed and edited the manuscript; Liu YT, Yu LP, and Zhang B conceptualized the study; Zhu DL and Li ZP supervised the study; Xie LD and He YF contributed to software; Song LL and Jin X validated the results; Zhang B provided resources, administered the project and acquired funding; all authors have read and approved the final manuscript.

AI contribution statement: During the preparation of this manuscript, AI tools were used only for language editing, grammar checking, and improving clarity. The authors carefully reviewed, revised, verified, and approved all AI-assisted outputs. No AI tools were used for study design, data collection, data analysis, statistical analysis, interpretation of results, or generation of figures and tables.

Supported by the National High Level Hospital Clinical Research Funding, No. 2025-NHLHCRF-JBGS-B-WZ-01 and No. 2025-NHLHCRF-JBGS-A-WZ-09; Capital’s Funds for Health Improvement and Research, No. 2024-1-4064; and the National Key Research and Development Program of China, No. 2018YFC1313902.

Institutional review board statement: The study protocol was reviewed and approved by the Ethics Committee of China-Japan Friendship Hospital (approval No. 2019-63-K43). This study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

Informed consent statement: All participants provided informed consent.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.

Data sharing statement: The data analyzed in this study are not publicly available due to privacy and ethical restrictions, but may be made available from the corresponding author upon reasonable request and with appropriate institutional approval.

Corresponding author: Bo Zhang, MD, Chief Physician, Professor, Department of Endocrinology, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing 100029, China. drbozhang@yahoo.com

Received: April 27, 2026
Revised: May 27, 2026
Accepted: June 25, 2026
Published online: September 15, 2026
Processing time: 128 Days and 11.2 Hours

Core Tip

Core Tip: Conventional glycemic markers may not fully capture early metabolic disturbances. In this cross-sectional study, untargeted plasma metabolomics profiled 200 participants across different glycemic stages, including normal glucose tolerance, isolated impaired fasting glucose, isolated impaired glucose tolerance, and newly diagnosed diabetes. We identified 18 core metabolites consistently altered across stages. A five-metabolite candidate panel showed exploratory potential to distinguish early dysglycemia. Weighted gene co-expression network analysis suggested module-level differences between impaired fasting glucose and impaired glucose tolerance metabolic modules, which remain exploratory and require validation in independent cohorts. These findings provide candidate features for early stratification of dysglycemia.