Higher Plasma Sphingosine-1-Phosphate Levels in Type 2 Diabetic Patients Have a Non-Linear Relationship with the Disease Prognostic Indices and Microvascular Complications: A Cross-Sectional Saudi Study.

The trend of increases in plasma S1P with complications is further detailed in Table 5 , where they were all significantly higher than in patients without complications, with an increasing trend from ophthalmopathy ( p = 0.018), neuropathy ( p = 0.007), nephropathy ( p = 0.004), and mixed complications ( p < 0.001).

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Furthermore, this sample size provided >95% power to detect the highly significant differences in continuous plasma S1P levels observed between the two cohorts.

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While some antidiabetic drugs may modulate sphingolipid metabolism [ 5 , 49 , 50 ], our data suggest that S1P elevation is primarily a marker of advanced disease rather than a treatment-specific effect, as the relationships had marginal significance.

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