Type 2 diabetes (T2D) is a complex metabolic disease characterized by multi-tissue insulin resistance and failure of the pancreatic β-cells to secrete sufficient amounts of insulin. Cells recruit transcription factors (TF) to specific genomic loci to regulate gene expression that consequently affects the protein and metabolite abundancies. Here we investigated the interplay of transcriptional and translational regulation, and its impact on metabolome and phenome for several insulin-resistant tissues from T2D donors. We implemented computational tools and multi-omics integrative approaches that can facilitate the selection of candidate combinatorial markers for T2D.

We developed a data-driven approach to identify putative regulatory regions and TF-interaction complexes. The cell-specific sets of regulatory regions were enriched for disease-related single nucleotide polymorphisms (SNPs), highlighting the importance of such loci towards the genomic stability and the regulation of gene expression. We employed a similar principle in a second study where we integrated single nucleus ribonucleic acid sequencing (snRNA-seq) with bulk targeted chromosome-conformation-capture (HiCap) and mass spectrometry (MS) proteomics from liver. We identified a putatively polymorphic site that may contribute to variation in the pharmacogenetics of fluoropyrimidines toxicity for the DPYD gene. Additionally, we found a complex regulatory network between a group of 16 enhancers and the SLC2A2 gene that has been linked to increased risk for hepatocellular carcinoma (HCC). Moreover, three enhancers harbored motif-breaking mutations located in regulatory regions of a cohort of 314 HCC cases, and were candidate contributors to malignancy.

In a cohort of 43 multi-organ donors we explored the alternating pattern of metabolites among visceral adipose tissue (VAT), pancreatic islets, skeletal muscle, liver and blood serum samples. A large fraction of lysophosphatidylcholines (LPC) decreased in muscle and serum of T2D donors, while a large number of carnitines increased in liver and blood of T2D donors, confirming that changes in metabolites occur in primary tissues, while their alterations in serum consist a secondary event. Next, we associated metabolite abundancies from 42 subjects to glucose uptake, fat content and volume of various organs measured by positron emission tomography/magnetic resonance imaging (PET/MRI). The fat content of the liver was positively associated with the amino acid tyrosine, and negatively associated with LPC(P-16:0). The insulin sensitivity of VAT and subcutaneous adipose tissue was positively associated with several LPCs, while the opposite applied to branch-chained amino acids. Finally, we presented the network visualization of a rule-based machine learning model that predicted non-diabetes and T2D in an “unseen” dataset with 78% accuracy.