## 4 Discussion
### Lysosomal Pathway  
Notably, after excluding MHC-related pathways, which may have spurious significance due to strong linkage, only two significant pathways remained: 'lysosome' for the pancreas and 'other glycan degradation' for skeletal muscle. The 'lysosome' pathway plays a critical role in various cellular processes, including apoptotic cell death, intracellular pathogen killing, antigen presentation, plasma membrane repair, cell adhesion and migration, energy metabolism, tumor invasion and metastasis, metabolic signaling, and gene regulation. Most importantly, lysosomes are responsible for the degradation of cellular waste materials through autophagy and endocytosis. The dysregulation of autophagy in pancreatic beta cells has been extensively studied in the context of T2 DM pathogenesis. Studies have shown that Zucker diabetic fatty rats exhibit ubiquitinated protein aggregates in pancreatic beta cells during hyperglycemia [19]. Additionally, knockout mice for the autophagy gene Atg7 showed reduced beta cell numbers, impaired glucose tolerance, and decreased insulin secretion [20]. The present study suggests that the pathogenic mechanism of T2 DM may involve a failure of the autophagic termination process associated with lysosomes. This finding aligns with previous studies that have observed the accumulation of autophagosomes in pancreatic beta cells in T2 DM, which is associated with impaired insulin secretion and beta cell apoptosis [20; 21; 22]. While the activation of the mTOR sig \begin{table}
\begin{tabular}{c c c c c} \hline \hline \multirow{2}{*}{**Tissue a**} & \multicolumn{2}{c}{**eGenes Relevant to Other Glycan**} & \multicolumn{2}{c}{**\(p\)-Value c**} \\  & \multicolumn{2}{c}{**Degradation**} & & \multicolumn{2}{c}{**\(p\)-Value c**} \\ \cline{2-5}  & **Name** & **No b** & **Raw** & **Adjusted d** \\ \hline M & NEU3, GBA, MAN2C1, GBA2 & 4 & \(\mathbf{3.0\times 10^{-3}}\) & \(\mathbf{4.2\times 10^{-2}}\) \\ \hline P & GBA, MAN2C1, GBA2 & 3 & \(\mathbf{4.6\times 10^{-3}}\) & \(5.0\times 10^{-2}\) \\ \hline AL & MAN2C1 & 1 & \(1.0\times 10^{-1}\) & \(2.9\times 10^{-1}\) \\ \hline AM & MAN2C1, GBA2 & 2 & \(\mathbf{3.3\times 10^{-2}}\) & \(2.1\times 10^{-1}\) \\ \hline AP & MAN2C1, GBA2 & 2 & \(\mathbf{1.6\times 10^{-2}}\) & \(9.3\times 10^{-2}\) \\ \hline LM & MAN2C1 & 1 & \(9.0\times 10^{-2}\) & \(2.4\times 10^{-1}\) \\ \hline LP & MAN2C1 & 1 & \(9.6\times 10^{-2}\) & \(2.7\times 10^{-1}\) \\ \hline MP & GBA, MAN2C1, GBA2 & 3 & \(\mathbf{9.4\times 10^{-4}}\) & \(\mathbf{7.7\times 10^{-3}}\) \\ \hline ALM & MAN2C1 & 1 & \(7.2\times 10^{-2}\) & \(1.5\times 10^{-1}\) \\ \hline ALP & MAN2C1 & 1 & \(8.1\times 10^{-2}\) & \(2.0\times 10^{-1}\) \\ \hline AMP & MAN2C1, GBA2 & 2 & \(\mathbf{1.0\times 10^{-2}}\) & \(5.1\times 10^{-2}\) \\ \hline LMP & MAN2C1 & 1 & \(7.6\times 10^{-2}\) & \(1.8\times 10^{-1}\) \\ \hline ALMP & MAN2C1 & 1 & \(7.2\times 10^{-2}\) & \(1.5\times 10^{-1}\) \\ \hline \hline \end{tabular}  
* Two or more letters indicate that enrichment was analyzed using eGenes shared by tissues. A: visceral adipose tissue; L: liver; M: skeletal muscle; P: pancreas. b There was a total of 18 other glycan degradation-related genes in the KEGG pathway. c Significance with \(p<0.05\) is presented in bold. d Adjusted \(p\)-values were obtained using the Benjamini-Hochberg method to correct for multiple testing.  
\end{table} 
Table 2: _Cont._naling pathway has received significant attention in the dysregulation of autophagy in T2 DM [23; 24], other mechanisms underlying the dysregulation of autophagy in T2 DM remain unclear. This study highlights the importance of investigating the failure of the autophagic termination process associated with lysosomes as a priority for understanding the pathogenesis of T2 DM. Understanding how lysosomal dysfunction contributes to T2 DM would lead to better diagnostic tools and strategies for early detection of the disease.