Patients group (P): we collected three blood samples (age 67 ± 8.64 years) in Uyghur patients with T2DM. T2DM diagnosis meets the 1999 World Health Organization Diabetes Diagnostic Criteria. According to medical history and family history, type 1 diabetes, young-onset adult diabetes, and mitochondrial diabetes are excluded. The patients have lived in Xinjiang for a long time, and three generations have not been married to other races, with no autoimmune disease; no serious heart, liver, and kidney disease; no malignant tumors; and non-pregnant or lactating women. Normal control group (N): three blood samples of normal glucose tolerance (NGT) (age 68.3 ± 6.94 years) were taken from Uyghur populations, respectively. All selected subjects were measured for blood pressure, body weight, height, waist circumference, hip circumference, fasting blood glucose (FPG), 2 h plasma glucose (2hPG), fasting insulin (FINS), fasting C-peptide (FCP), glycated hemoglobin (HbA1c), and serum lipids, among others. The insulin resistance index of the steady-state model was calculated (HOMA-IR = FPG×FINS/22.5). Characteristics of sample collection of proteomic analysis are shown in Supplementary Table S1. In addition, another 60 Uyghur patients with T2DM and 60 sex- and age- (±3 years) match healthy controls were recruited from the same hospital used for further validation. The study was approved by the ethics committee of the First Affiliated Hospital of Shihezi University School of Medicine, and the consent was obtained from all patients. About 5 ml of fasting venous blood was collected from each subject (EDTA anticoagulation) and centrifuged at 3,000 rpm for 10 min. Separated serum was stored at −80°C.

Samples were taken from the −80°C freezer, centrifuged at 12,000 g for 10 min at 4°C, and the supernatant of the cell debris was removed and transferred to a new centrifuge tube. Then, the top 12 high abundance proteins were removed by Pierce™ Top 12 Abundant Protein Depletion Spin Columns Kit (Thermo Fisher, United States). After 7-8-fold dilution, the protein concentration was determined using the BCA kit (TIANGEN, China) according to the manufacturer’s instructions.

Take the same amount of protein in each sample, add the same volume of pre-chilled acetone, vortex, and mix. Then, add four times the volume of the pre-chilled acetone and precipitate at −20°C for 2 h. Centrifuge at 4,500 g for 5 min, discard the supernatant, and wash the precipitate two to three times with pre-cooled acetone. After drying the precipitate, add an appropriate amount of 8 M urea, reconstitute it with ultrasound, adjust the volume to the same with the lysate, then add dithiothreitol to make the final concentration of 5 mM, and reduce at 56°C for 30 min. After that, iodoacetamide was added to make the final concentration of 11 mM and incubated at room temperature in the dark for 15 min. Then, the protein sample was diluted by adding 100 mM TEAB to achieve a urea concentration of less than 2 M. Trypsin (Promega, United States) was added at a mass ratio of 1:50 (trypsin: protein) and digested overnight at 37°C. Add trypsin at a mass ratio of 1:100 (trypsin: protein) and a second 4 h digestion.

The trypsin-digested peptides were desalted using Strata X C18 (Phenomenex, United States) and vacuum freeze-dried. Dissolve the peptides with 0.5 M TEAB and label the peptides according to the manufacturer’s protocol for Tandem Mass Tags (TMTs) kit (Thermo Fisher, United States). The simple operation was as follows: one unit of TMT reagent was thawed, dissolved in acetonitrile, mixed with the peptide, and incubated at room temperature for 2 h. Next, the labeled peptides were mixed, desalted, and dried by vacuum centrifugation.

The tryptic peptides were fractionated by high pH reverse-phase HPLC using Thermo Betasil C18 column (5 μm particles, 10 mm ID, 250 mm length). Briefly, the peptides were separated into 60 fractions using a gradient of 8–32% acetonitrile (pH = 9.0) over 60 min. Then, the peptides were combined into four fractions and vacuum freeze-dried for subsequent operations.

To enrich modified peptides, tryptic peptides were dissolved in IP buffer solution (100 mM NaCl, 1 mM EDTA, 50 mM Tris-HCl, 0.5% NP-40, pH of 8.0). Firstly, the supernatant was transferred into the anti-acetyllysine antibody-conjugated agarose beads (PTM-104, PTM Biolabs, Hangzhou, China), placed on a rotary shaker at 4°C, and incubated overnight. Secondly, the beads were washed four times with IP buffer solution and twice with deionized water. The bound peptides were eluted using a 0.1% trifluoroacetic acid eluate and eluted three times. The eluate was collected and vacuum-dried, finally desalting according to C18 ZipTips (Millipore, United States) instructions, vacuum drying, and refrigerating for LC-MS/MS analysis.

Solvent A is a solution containing 0.1% formic acid and 2% acetonitrile. Solvent B is a solution containing 0.1% formic acid and 90% acetonitrile. The tryptic peptides were dissolved in solvent A by liquid chromatography and separated using an EASY-nLC 1000 Ultra Performance Liquid Chromatography (UPLC) system. The specific gradient was comprised of an increase from 10 to 24% of solvent B over 26 min, 24–38% in 8 min (26–34 min), and climbing to 80% in 3 min (34–37 min), then holding at 80% for the last 3 min (37–40 min), and moving to a constant flow rate of 700 nL/min. The peptides were separated by an ultra-high performance liquid phase system, injected into an NSI ion source for ionization, and then analyzed by Orbitrap Fusion mass spectrometry. The primary mass spectral scan range is set to 350–1550 m/z, and the scan resolution is set to 60,000. The MS/MS scan range has a fixed starting point of 100 m/z, and the Orbitrap scan resolution is set to 15,000.

Total RNA of peripheral blood mononuclear cells (PBMNCs) was extracted using TRIzol (Invitrogen, CA, United States). The purity and concentration of total RNA samples were quantified using the NanoDrop ND-1000 (NanoDrop Technologies/Thermo Scientific, Wilmington, DE, United States). Total RNA (2 μg) from each sample was reverse-transcribed using the Hairpin-it qRT-PCR kit (GenePharma, Shanghai, China) according to the manufacturer’s instructions. 20 μl reaction volume contained 10 μl Real-Time PCR Master Mix (SYBR), 0.4 μl 10 μM Gene-Specific Primer Set (0.2 μM final), 0.4 μl ROX reference dye (50×), 0.2 μl Taq DNA polymerase, and 2 μl of template cDNA and DEPC-treated water. GAPDH was used as an internal control to quantify and normalize the results. The 2^-△△CT value was used for comparative quantitation. All qRT-PCRs were performed in triplicate. The primers were obtained from GenePharma (Shanghai, China), and the sequences are shown in Supplementary Table S2.

Treated PBMNCs were lysed in RIPA buffer, and protein content was determined using a BCA Protein Assay Kit (cat. P0011, Beyotime). Fifty milligrams of protein samples was used for sodium dodecyl sulfate (SDS)/polyacrylamide gel electrophoresis (PAGE) and then transferred onto a PVDF membranes (Millipore, MA, United States). After blocking with 5% non-fat milk for 1 h, the membranes were incubated overnight at 4°C with the following primary antibodies: H4 (ab10158, Abcam, United Kingdom), H3.3C (ab150417, Abcam, United Kingdom), = two histone lysine acetylation site-specific antibodies, H3K23 acetyl antibody and H4K16 acetyl antibody (PTM Biolabs, Hangzhou, China), and GAPDH (cat. TA-08; ZSGB-BIO, China). After incubation with secondary antibodies (1:10,000), the specific bands were visualized by an electrochemiluminescence detection system. Relative protein content was analyzed by ImageJ software and normalized to loading controls.

INS-1 cells (rat insulinoma cells) were purchased from Enzyme Biotechnology (Shanghai, China). INS-1 cells were cultured in 15% fetal bovine serum, 10 mmol/L 2-[4-(2-hydroxyethyl)-1-piperazinyl] ethanesulfonic acid (HEPES), 100 U/ml penicillin, 100 μg/ml streptomycin, and 50 μmol/L β-mercaptoethanol in DMEM (low sugar) medium, at 37°C with 5% CO₂. According to the experiment, INS-1 cells were cultured in 5.6 mmol/L glucose (normal glucose, NG group) and 33.3 mmol/L glucose (high glucose, HG group).

INS-1 cells were fixed by 1% formaldehyde for 10 min at room temperature and lysed with ChIP lysis buffer (50 mM Tris HCl, pH 8.0, 5 mM EDTA, 1% SDS) for 10 min at 4°C. In a centrifuge tube, vortex, mix, and divide into multiple portions, each 500 uL, and place them in a 1.5 ml centrifuge tube for ultrasonic disruption. The ultrasonic power, ultrasonic time, interval time, and ultrasonic times are optimized. In the experiment, the ultrasonic power was set to 15 W (6%), 20 W (8%), 25 W (10%), and 30 W (12%); the ultrasonic time was set to 1, 3, and 5 s; the ultrasonic interval was set to 10, 20, 30, and 40 s; and the number of sonication was set to 15, 25, 30, and 40 times. When a certain condition is optimized, the other three conditions are fixed unchanged. The fixed value of each condition in this experiment is the ultrasonic power of 25 W (10%), the ultrasonic working time of 5 s, the interval of 40 s, and the ultrasonic wave of 30 times. After the samples were interrupted by an ultrasonic breaker, they were centrifuged at 10,000 r/min for 5 min at 4°C, and 400 uL was taken. The supernatant was aliquoted into two new centrifuge tubes, one for the uncross-linked chromosome assay and the other for the CHIP assay. Take 200 uL of ultrasonic sample and cross-linked sample, respectively, and add 8 uL of 5 mol/L. After incubation with NaCl for 6 h or overnight at 65°C, the cross-linked DNA and Hacl protein were de-cross-linked and then extracted with an extraction buffer. Extract once, then extract with chloroform. Add 20 g glycogen and 1 ml absolute ethanol to the extract to precipitate DNA for 1 h, and centrifuge at 13,000 r/min for 10 min at 4°C. Finally, 1 uL of RNase (10 mg/ml) was added and incubated at 37°C for 30 min. The above samples were subjected to 1% agarose gel electrophoresis to detect the ultrasonic effect of the samples to determine the optimized results of each condition. After sonication, the lysate was centrifuged, and the supernatant was collected and precleaned in dilution buffer (20 mM Tris HCl, pH 8.0, 2 mM EDTA, 150 mM NaCl, 1% Triton X-100) with protein G or A sepharose and salmon DNA for 2 h at 4°C. The precleaned samples were divided equally and incubated with the H4 antibody (ab10158, Abcam, United Kingdom) overnight at 4°C. Next, protein G or A sepharose was added into each sample and incubated for 2 h at 4°C. The beads were washed with TSE I, TSE II, buffer III, and tris-EDTA buffer sequentially. The samples were heated at 65°C for at least 6 h to reverse the cross-link. Then, DNA was purified by a PCR Cleaning Kit (Macherey-Nagel). Finally, the immunoprecipitated DNA was quantified by real-time PCR (Sybr green approach for heterochromatic loci).

INS-1 cells were seeded on a laser confocal culture dish and cultured in high glucose for 24–48 h. The cells were fixed (4% paraformaldehyde) for 30 min, washed 3 times with PBS, then permeabilized with 0.3% Triton X-100 for 20 min, and blocked with 1% BSA for 1 h. They were incubated overnight at 37.0°C in AcH4 (K16) and AcH3 (K23) antibodies (1:100). After washing, the sections were incubated with Alexa Fluor 488 goat anti-mouse IgG (Invitrogen, 1:1000) and Alexa Fluor 594 goat anti-rabbit IgG (Invitrogen; 1:1000) for 1 h at room temperature. Finally, add DAPI to stain the INS-1 cell nucleus (blue). The image was obtained by confocal (Leica, Germany).

The resulting MS/MS data were processed using the Maxquant search engine (v.1.5.2.8). Retrieval parameter settings: the database is SwissProt Human (20,317 sequences), an anti-library is added to calculate the false positive rate (FDR) caused by random matching, and a common contamination library is added to the database to eliminate contaminating proteins in the identification results. The effect of enzyme digestion is set to trypsin/P. The number of missed cleavage sites is set to four. The minimum length of the peptide is set to seven amino acid residues. The ion mass error tolerance was set at 20 and 5 ppm, respectively, and the mass error tolerance for secondary fragment ions was 0.02 Da. Cysteine alkylation was set as fixed modification, and variable modification as oxidation of methionine, acetylation of protein N-terminus, and acetylation of lysine. The quantification method was set to TMT-6plex, and the FDR of protein identification and PSM identification were both set to 1%. The cysteine alkylation was set as fixed modification, and variable modification as methionine oxidation, protein N-terminal acetylation, and lysine acetylation. The quantitative method is set to TMT-6plex, and the FDR for protein identification and PSM identification is set to 1%. Gene Ontology (GO) annotation proteome was derived from the UniProt-GOA database. If some identified proteins were not annotated, the InterProScan soft would be used to annotate protein’s GO functional based on the protein sequence alignment method. Annotate the identified proteins domain functional description using the InterPro domain database. Kyoto Encyclopedia of Genes and Genomes (KEGG) database was used to annotate the protein pathway. We used WoLF PSORT, a subcellular localization prediction soft, to predict subcellular localization. Soft MoMo (motif-x algorithm) was used to analyze the model of sequences constituted with amino acids in specific positions of modify-21-mers. The main software used in the analysis can be found in Supplementary Table S3.

In this study, the statistical analysis software used includes SPSS 19.0 and Origin 8.5. Quantitative values are expressed as mean ± standard deviation (SD), and statistical analyses were performed using Student’s t-test. All verification experiments (e.g., qRT-RCR and western) require three biological replicates. Significance in statistical analysis was defined as p < 0.05.

A total of 39,363 MS/MS were obtained by LC-MS/MS. A schematic diagram of the technical route is shown in Supplementary Figure S1A. After searching by protein data, the available effective MS/MSs were 2041, and the utilization rate was 5.2%. In addition, 643 peptide fragments and 411 acetylated peptide fragments were identified by an effective MS/MSs analysis. Most of the peptides were distributed in 7–20 amino acids (Supplementary Figure S1B), consistent with the general rule based on trypsin enzymatic hydrolysis and high energy collision-induced dissociation (HCD) fragmentation. Among them, peptide fragments of less than five amino acids cannot produce effective sequence identification due to the small number of fragment ions generated. Peptides larger than 20 amino acids were not suitable for fragmentation of HCD due to their high mass and charge. The distribution of peptide lengths identified by mass spectrometry meets the quality control requirements. The number of modification sites corresponding to each protein is shown in Supplementary Figure S1C, and the mass precision map of the MS/MSs data is shown in Supplementary Figure S1D. The SDS-PAGE of protein extraction quality control is shown in Supplementary Figure S2, and the initial protein concentration determination results of each sample are shown in Supplementary Figure S4. Taken together, according to protein extraction quality control standards, our protein extraction quality meets the requirements. Herein, we use two statistical analysis methods, relative standard deviation (RSD, Figure 1A) and Pearson’s correlation coefficient (Figure 1B), to evaluate sample repeatability. In order to ensure a high degree of credibility of the results, we used the standard of localization probability >0.75 to filter the authentication data. One is the highest score. In total, 422 acetylation sites from 120 acetylated proteins were identified, of which 347 sites on 103 proteins have quantitative information (Figure 1C).

In this study, quantitatively repeat the experiment through three modifications to obtain the quantitative value of each sample in the three replicates. Firstly, we calculated and compared the differential modification of the modification sites between two samples in the group. Each sample is repeated three times to obtain the average value of quantitative values and then calculated for the ratio of the average value between the two samples, which is used as relative quantification (ratio) of final differential modification of group comparison. Secondly, we calculated the significant p-value of the different modifications. Taking the quantitative value of each sample as log₂ so that the data conforms to the normal distribution, we then calculated the p-value using the two-sample t-test method (two-tailed). When p-value < 0.05, the difference modification amount is more than 1.3 as a significant upregulation change threshold, and less than 1/1.3 is a significant downregulation. According to screening criteria, we construct a volcano plot of differentially expressed modification sites. In Figure 1D, six differentially modified proteins have been marked (as blue and red circles). Among them, compared with the control group, we found that the modification levels of the three sites were upregulated, and the five sites were downregulated (Table 1 for details). The specific distribution of differentially expressed proteins and modification sites in different comparison groups is shown in Figure 1E. Among them, each sample was subjected to three technical repetitions.

In order to thoroughly understand the modified proteins identified and quantified in the data, we detailed the functions and characteristics of these proteins from the aspects of GO, protein domain, KEGG pathway, and subcellular structure localization. The GO annotations are divided into three broad categories, biological process (BP), cellular component (CC), and molecular function (MF), which explain the biological effects of proteins from different perspectives. We performed statistics on the distribution of proteins corresponding to differentially expressed modification sites under each GO category (second level), as shown in Figure 2A. Moreover, we constructed a subcellular localization chart of proteins corresponding to differentially manifest modification sites (Figure 2B). Clusters of Orthologous Groups (COG) of proteins is a database of NCBI. COG for eukaryotic complete genomes is called the KOG. The proteins corresponding to differentially expressed modification sites were subjected to COG/KOG functional classification statistics by database alignment analysis (Figure 2C).

For enrichment, the p-values obtained by Fisher’s exact test were used to construct a bubble diagram to reveal the functional classification and pathway for significant enrichment of differentially modified proteins (p < 0.05). Therefore, we drew a GO enrichment bubble plot of proteins corresponding to differentially expressed modification sites in three categories (Figures 3A–C). Similarly, we constructed a KEGG pathway enrichment bubble plot of proteins corresponding to differentially manifest modification sites (Figure 3D). The protein domain enrichment bubble plot of proteins corresponding to differentially expressed modification sites is shown in Supplementary Figure S3. In the bubble chart, the circle color indicated the p-value of the enrichment significance, and the circle size indicated the number of differentially modified proteins in the functional classification or pathway. Furthermore, the directed acyclic graph (DAG) of each GO category for proteins corresponding to differentially expressed modification sites is shown in Figure 4.

KEGG is an information network that links intermolecular interactions. Combining our previous results (Table 1), we performed significant KEGG pathway enrichment on proteins corresponding to differentially expressed modification sites to help us understand the function and role of protein acetylation in T2DM in depth. Apolipoprotein B (ApoB-100) protein corresponding to differential acetylation site was enriched into the cholesterol metabolism pathway (hsa04979, Figure 5A). Proteins of kininogen-1 (KNG1) and plasma protease C1 inhibitor (SERPING1) corresponding to differential acetylation sites were enriched into the complement and coagulation cascades pathway (hsa04610, Figure 5B). Histones H4 and H3.3C corresponding to differential acetylation sites were enriched into the systemic lupus erythematosus pathway (hsa05322, Figure 5C).

Cluster analysis of differentially modified proteins in different comparison groups was performed to find the correlation of the function of differentially modified proteins (Figure 6). The specific method was to use hierarchical clustering to collect related functions in different groups according to the p-value of the enrichment test (Fisher’s exact test) and draw it as a heat map. In addition, the horizontal direction of the heat map represents different comparison groups, and the vertical direction is a description of the differential modification-related function (GO, KEGG pathway, protein domain). Different sets of differentially modified proteins and their functional descriptions correspond to the color blocks, suggesting the strength of different enrichment levels. Among them, red indicates strong enrichment and blue indicates weak enrichment.

By counting the regularity of upstream and downstream amino acids of all acetylation modification sites in the sample, the regular trend of the amino acid sequence in the acetylation site was calculated. However, it is a pity that we did not find enrichment to the modified site feature sequence (Supplementary Figure S4).

The differentially modified protein database number or protein sequence screened in different groups were compared with the STRING (v.10.5) protein network database, and the differential protein interaction relationships were extracted according to the confidence score >0.7 (high confidence). Then, visualize the differential protein interaction network using the R package “networkD3” tool (Figure 7A). The circle size represents the number of differentially modified proteins and their interacting proteins. The larger the circle, the more proteins it interacts with, indicating the more important the protein in the network.

We selected ApoB-100 and histones H4 and H3.3C for the level of mRNA detection by qRT-PCR. For verification, we collected 60 cases of Uyghur T2DM subjects and normal individuals, respectively (the same batch as proteomic analysis). Moreover, we detected differentially expressed modification sites in PBMNCs. The result of qRT-PCR in T2DM patients demonstrated that they were consistent with the proteomic analysis (Figure 7B). Then, we detected the protein levels of histones H4 and H3.3C by western blot. The results showed that the protein levels of H4 and H3.3C in T2DM patients decreased compared to normal controls (Supplementary Figure S5). Subsequently, we conducted a specific detection of the acetylated protein levels at the H4K16 and H3K23 sites between Uyghur T2DM and the control group (Figure 7C). The results showed that compared with the control group, the H4K16 and H3.3CK23 acetylation levels in Uyghur T2DM were significantly lower. In addition, a quantitative ChIP assay also revealed that acetylated H4 was downregulated in both SAT2 and SATa loci in INS-1 cells with high glucose (Figure 7D). Taken together, these provide a theoretical basis for us to understand the protein acetylation status of Uyghur patients with T2DM.

The double immunofluorescence staining results of AcH4 (K16) and AcH3 (K23) in high glucose cultured INS-1 cells are shown in Figure 8A. These two modifications are detected as distinct punctate regions in the nucleus. AcH4 (K16) is mainly observed in the peripheral heterochromatin area, while AcH3 (K23) can be observed in the peripheral heterochromatin area and the central euchromatin area of the nucleus. Quantitative intensity analysis using LAS X Life Science image analysis software confirmed the different immunofluorescence intensity peaks between AcH4 (K16) and AcH3 (K23) (seen in Figure 8B).