{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:40:37Z","timestamp":1792100437820,"version":"4.4.0"},"reference-count":49,"publisher":"American Diabetes Association","issue":"2","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:p>Macro- and microvascular complications of type 2 diabetes (T2D), obesity, and dyslipidemia share common metabolic pathways. In this study, using a total of 1,300 metabolites from 996 Qatari adults (57% with T2D) and 1,159 metabolites from an independent cohort of 2,618 individuals from the Qatar BioBank (11% with T2D), we identified 373 metabolites associated with T2D, obesity, retinopathy, dyslipidemia, and lipoprotein levels, 161 of which were novel. Novel metabolites included phospholipids, sphingolipids, lysolipids, fatty acids, dipeptides, and metabolites of the urea cycle and xanthine, steroid, and glutathione metabolism. The identified metabolites enrich pathways of oxidative stress, lipotoxicity, glucotoxicity, and proteolysis. Second, we identified 15 patterns we defined as \u201cmetabo-clinical signatures.\u201d These are clusters of patients with T2D who group together based on metabolite levels and reveal the same clustering in two or more clinical variables (obesity, LDL, HDL, triglycerides, and retinopathy). These signatures revealed metabolic pathways associated with different clinical patterns and identified patients with extreme (very high\/low) clinical variables associated with extreme metabolite levels in specific pathways. Among our novel findings are the role of N-acetylmethionine in retinopathy in conjunction with dyslipidemia and the possible roles of N-acetylvaline and pyroglutamine in association with high cholesterol levels and kidney function.<\/jats:p>","DOI":"10.2337\/db21-0490","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T13:20:14Z","timestamp":1635945614000},"page":"184-205","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":105,"title":["Metabolic and Metabo-Clinical Signatures of Type 2 Diabetes, Obesity, Retinopathy, and Dyslipidemia"],"prefix":"10.2337","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1918-0331","authenticated-orcid":false,"given":"Noha A.","family":"Yousri","sequence":"first","affiliation":[{"name":"Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar"},{"name":"Computer and Systems Engineering, Alexandria University, Alexandria, 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Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Chidiac","sequence":"additional","affiliation":[{"name":"Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald G.","family":"Crystal","sequence":"additional","affiliation":[{"name":"Genetic Medicine, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid A.","family":"Fakhro","sequence":"additional","affiliation":[{"name":"Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar"},{"name":"Translational Research, Sidra Medical and Research Center, Doha, Qatar"},{"name":"College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, 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