Carbon Nanostructure-Initiator Mass Spectrometry for Metabolic Biomarker Detection of Prediabetes

Prediabetes is a borderline condition that can progress to type 2 diabetes mellitus (T2DM) and develop into other severe diseases without timely intervention. Over 80% individuals with prediabetes are unaware that they have the condition. Identifying metabolic biomarkers for prediabetes diagnosis is crucial for preventing its progression to T2DM. In this study, we introduce the first carbon nanostructure initiator mass spectrometry (C-NIMS) platform for metabolic detection. By using macroporous carbon microspheres with a large pore size of ≈80 nm and a high pore volume of 7.5 cm³ g^–1 to load initiators, the detection sensitivity can be enhanced by three orders. With the developed C-NIMS platform, plasma metabolic fingerprints (PMFs) are constructed for the successful differentiation of prediabetes, T2DM, and normal conditions in mouse plasma samples, showing AUCs of 0.903–0.972. The development of the C-NIMS platform presents a new branch in the research of mass spectrometry (MS)-based technology, offering a promising approach to diagnostic applications and biomarker identification.