Objective

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To analyze the biological basis of qi and yin deficiency syndrome in type 2 diabetes by using proteomics and metabolomics technology.

Methods

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From May 2018 to September 2018， 30 cases of type 2 diabetes with qi-yin deficiency syndrome （group Q）， 30 cases of type 2 diabetes with non qi-yin deficiency syndrome （group F） and 30 cases of healthy control group （group N） were enrolled in Beijing Shijitan Hospital affiliated to the Capital Medical University. Label free proteomics method was used to analyze the differential proteins of three groups of plasma samples，and the differential expression proteins between groups were obtained. KEGG pathway and String database were used to analyze the bioinformatics of the differential expression proteins. LC-MS combined technology was used to analyze differential metabolites in three groups of plasma samples. A combination of multidimensional analysis and single dimensional analysis was used to screen differential metabolites among the three groups. The HMDB database was searched and identified， and KEGG path analysis was performed on the screened differential metabolites to explore the metabolic pathways in which differential metabolites may participate.

Results

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The results of plasma proteomics were that 119 differential proteins were screened between the type 2 diabetes group and the healthy control group，of which 55 were up-regulated and 64 were down-regulated；89 differential proteins were screened out between type 2 diabetes with qi-yin deficiency syndrome and non qi-yin deficiency syndrome， among which 51 were up-regulated and 38 were down-regulated；18 differentially expressed proteins were screened out between the type 2 diabetes group with qi and yin deficiency syndrome，the non qi and yin deficiency syndrome group and the healthy control group，of which 8 were up-regulated and 10 were down-regulated. KEGG pathway analysis found that PI3K-AKT signaling pathway， renin secretion， IL-17 and other signaling pathways were closely related to the occurrence and development of qi-yin deficiency syndrome in type 2 diabetes. The results of plasma metabonomics were that 32 differential metabolites were screened out between the type 2 diabetes group and the healthy control group. KEGG pathway analysis found that branched chain amino acid （BCAAs）synthesis and metabolic pathway， glycerol phospholipid metabolism， alanine， aspartic acid and glutamic acid metabolic pathway may be closely related to the occurrence and development of type 2 diabetes. Further integration of proteomics and metabolomics results found that BCAAs were closely related to PI3K-AKT signaling pathway.

Conclusion

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High levels of BCAAs in plasma may cause damage to insulin signaling pathway by inhibiting PI3K-AKT pathway， leading to the occurrence and development of Qi and Yin deficiency syndrome in type 2 diabetes.