Metabolomic risk predictors of diabetic foot complications: A longitudinal observational study in type 1 diabetes
Authors' conclusion
This study identified novel circulating metabolites, particularly those of the pentose phosphate pathway, associated with the risk of diabetic foot complications.
Study context
- Population
- Individuals with T1D, Steno Diabetes Center Copenhagen; median age 55 (47, 64) years, diabetes duration 35 (25, 44) years
- Participants
- 637 individuals
- Outcome
- Associations of 75 serum metabolites with prevalent and incident diabetic foot complications (foot ulcers and lower extremity amputations)
- Follow-up
- Median 10 years
Methodological detailsnon-targeted metabolomics, mass spectrometry, independent cohort replication
- Non-targeted metabolomics
- Mass spectrometry
- Independent cohort replication
Main finding
As reported in the abstract
Metabolites associated with diabetic foot complications after adjustment
- Crude models: metabolites associated with prevalent amputations
- 6
- Crude models: metabolites associated with incident ulcers
- 11
- Adjusted: threonine and succinic acid associated with prevalent amputations
- p < 0.05
- Adjusted: ribonic acid and incident ulcers, HR per percentage-increase
- 1.02 (1.00-1.04) (95% CI)
- Adjusted: nonanoic acid and incident ulcers, HR
- 0.96 (0.94-0.99) (95% CI)
Observational data: associations, not effects.
Further findings
Replication: ribonic acid and incident diabetic foot ulcers in an independent cohort
- Association replicated
- P < 0.05
Original publication
Metabolomic risk predictors of diabetic foot complications: A longitudinal observational study in type 1 diabetes. Diabetes Obes Metab. Published 12 August 2025. doi:10.
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