Evidence map›Paper›PMID 40798864›Full record

Observational studyDiabetes, obesity & metabolism2025

Metabolomic risk predictors of diabetic foot complications: A longitudinal observational study in type 1 diabetes.

Jonas A Andersen, Tommi Suvitaival, Kajetan Trošt, María J Romero-Lado, Simone Theilade, Ismo Matias Mattila, Marie Frimodt-Møller, Anne Rasmussen, Peter Rossing, Cristina Legido-Quigley and 1 more

Abstract readObservational Study
In one paragraph

Observational study in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jonas A AndersenSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0001-5213-5888
Tommi SuvitaivalSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-2583-4912
Kajetan TroštSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-3863-5269
María J Romero-LadoSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0009-0001-9500-3292
Simone TheiladeSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-1151-8951
Ismo Matias MattilaSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0001-9597-7831
Marie Frimodt-MøllerSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-8486-1515
Anne RasmussenSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0001-9562-9351
Peter RossingSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-1531-4294
Cristina Legido-QuigleySteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-4018-214X
Tarunveer Singh AhluwaliaSteno Diabetes Center Copenhagen, Herlev, Denmark.ORCID 0000-0002-7464-3354

Funding

Nordsjællands HospitalNovo Nordisk Foundation NNF23OC0084081Steno Diabetes Center Copenhagen
6 · The paper itself

Abstract

aimsDiabetic foot complications are a growing challenge for both individuals and society, underscoring the need for medical treatments and reliable risk markers. This study aimed to identify circulating metabolites associated with the prevalence and incidence of diabetic foot complications in individuals with type 1 diabetes (T1D). MATERIALS AND

methodsA non-targeted panel of 75 serum metabolites was measured via mass spectrometry in 637 individuals with T1D from the Steno Diabetes Center Copenhagen, with a median follow-up of 10 years. Associations with diabetic foot complications (foot ulcers and lower extremity amputations) were assessed using linear regression for prevalent and Cox models for incident outcomes. Metabolites with significant crude associations (after multiple testing correction) were further adjusted for key confounders including demographics, clinical variables, lipid profile and renal function, using R statistics.

resultsParticipants had a median (interquartile range) age of 55 (47, 64) years, diabetes duration of 35 (25, 44) years and HbA1c levels of 64 (8%) (56, 72 (7.3%, 8.7%)) mmol/mol. In crude models, six metabolites were associated with prevalent amputations and 11 with incident ulcers. After adjustment, threonine and succinic acid remained associated with prevalent amputations (p < 0.05). Ribonic acid (Hazard Ratio [HR] per percentage-increase: 1.02; 95% CI: 1.00-1.04) and nonanoic acid (HR: 0.96; 95% CI: 0.94-0.99) remained significantly associated with incident ulcers. The association between ribonic acid and incident diabetic foot ulcers was replicated in an independent cohort (p < 0.05).

conclusionsThis study identified novel circulating metabolites, particularly those of the pentose phosphate pathway, associated with the risk of diabetic foot complications.

Indexed as

Diabetes Mellitus, Type 1Diabetic FootAdultAmputation, SurgicalBiomarkersDenmarkFemaleHumansIncidenceLongitudinal StudiesMaleMetabolomicsMiddle AgedPrevalenceRisk FactorsBiomarkersclinical trialcohort studydiabetes complicationstype 1 diabetes

Identifiers

PMID40798864
PMCPMC12515773

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.