{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:16Z","timestamp":1792384876103,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["0074491"],"award-info":[{"award-number":["0074491"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distal symmetrical polyneuropathy (DSPN) is a common complication of type 1 diabetes (T1D), yet validated biomarkers for early detection or prognosis are lacking. Metabolic disturbances driven by chronic hyperglycemia and dyslipidemia contribute to DSPN development and progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used untargeted serum liquid chromatography\u2010mass spectrometry lipidomics to identify DSPN biomarkers. The discovery cohort included 153 individuals with T1D (109 with and 44 without DSPN) and 50 non\u2010diabetic controls. The independent validation cohort included 99 individuals with T1D with established DSPN status. Key lipids were identified using multivariate modelling, followed by ANCOVA and adjusted post hoc tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 543 lipid species were identified in the discovery cohort. Among these, 14 lipids were associated with DSPN. Of which, 6 lipids, namely Cer(d42:1), PC(36:4), LPC(16:0), LPE(18:1), PE(36:2), and PE(O\u201040:5) or PE(P\u201040:4), showed a clear pattern among non\u2010diabetic individuals, people affected by T1D with and without DSPN. In the validation cohort, 3 of the 6 initially identified lipids showed the same directional changes as in the discovery cohort. A logistic regression model combining the six lipid biomarkers with HbA1c, diastolic blood pressure, and age achieved AUCs of 0.83 (95% CI, 0.76\u20130.91) in the discovery cohort and 0.81 (95% CI, 0.73\u20130.90) in the validation cohort for detecting DSPN in T1D. AUC improvement was not significant by DeLong's test in either cohort (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.086 and 0.089) but was significant when combined using Fisher's method (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20099.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Additionally, 22 lipid species differed significantly between painful and painless DSPN.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified a reproducible lipidomic signature discriminating DSPN in type 1 diabetes. Painful DSPN was characterized by reduced unsaturated PC\/PE and increased sphingolipids, offering new insight into disease pathophysiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71257","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:28:06Z","timestamp":1788254886000},"page":"10670-10682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Lipidomics Profiling Identify Novel Biomarkers of Distal Symmetrical Polyneuropathy in Type 1 Diabetes"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7907-5421","authenticated-orcid":false,"given":"Tik","family":"Muk","sequence":"first","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Okdahl","sequence":"additional","affiliation":[{"name":"Mech\u2010Sense, Department of Gastroenterology and Hepatology Aalborg University Hospital and Clinical Institute, Aalborg University  Aalborg Denmark"},{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Steno Diabetes Center Odense  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6683-6375","authenticated-orcid":false,"given":"Marietta","family":"Kokla","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2583-4912","authenticated-orcid":false,"given":"Tommi","family":"Suvitaival","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3322-5030","authenticated-orcid":false,"given":"Gurjeet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-7831","authenticated-orcid":false,"given":"Ismo M.","family":"Mattila","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3401-8649","authenticated-orcid":false,"given":"Simon M.","family":"Kienle","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Buhl","sequence":"additional","affiliation":[{"name":"Department of Neurology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knud","family":"Yderstr\u00e6de","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Odense  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3487-6380","authenticated-orcid":false,"given":"Troels S.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Neurology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3274-5448","authenticated-orcid":false,"given":"Flemming","family":"Pociot","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1598-6023","authenticated-orcid":false,"given":"Birgitte","family":"Brock","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-214X","authenticated-orcid":false,"given":"Cristina","family":"Legido\u2010Quigley","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen  Herlev Denmark"},{"name":"Institute of Pharmaceutical Science, School of Life Science &amp; Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7082-9576","authenticated-orcid":false,"given":"P\u00e1ll","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Danish Pain Research Centre, Department of 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