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Metabolome could reveal biomarkers for earlier type 2 diabetes diagnosis
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Diagnosing type 2 diabetes through blood glucose levels should be reconsidered, with blood vessels already potentially damaged by the time levels rise, according to research published in PLOS ONE.
The metabolome or total biochemical markers in the blood, including fat metabolites, could provide alternative indicators for disease development before patients even reach the pre-diabetes stage, according to a press release from the University of Manchester, United Kingdom.
“We found that several groups of fat metabolites, also linked to body fat, were changed in the blood, as were others including some amino acids and to some extent vitamin D, before glucose levels increased,” J. Kennedy Cruickshank, MD, of King’s College London, said in the release. Simon Anderson, PhD, MRCP, of the University of Manchester, along with Cruickshank and colleagues, looked at women from the multicenter Hyperglycemia and Pregnancy Outcome study, focusing on the effect of glycemia below overt diabetes during gestation. Participants were at least 3 months pregnant and not taking antihypertensive drugs or any chronic therapies.
Based on glucose tolerance during a previous index pregnancy, the women were stratified into three risk groups: overt gestational diabetes (GDM group; n=18); glucose levels in the upper quartile but below gestational diabetes levels (n=45); and glucose below the median glucose values (controls; n=43).
Follow-up serum samples were collected, on average, 22 months post-natal and randomly analyzed using liquid chromatography paired with electrospray hybrid mass spectrometer. The researchers used principal component and multivariate methods for statistical analysis.
Differences were seen between groups in waist circumference (GDM, 86 cm; 95% CI, 79-91 vs. controls, 80 cm; 95% CI, 76-84). Adiponectin was 33% lower in GDM (P=.004); fasting glucose, post-prandial glucose and HbA1c were also lower in GDM but remained within normal range.
Metabolite profiles between the two at-risk groups and controls were substantially different, especially phospholipids (four metabolites with P≤.01), acylcarnitines (three with P≤.02), short- and long-chain fatty acids (three with P≤.03) and diglycerides (four with P≤.05).
“To help clarify the metabolic conditions that lead to the development of type 2 diabetes, further assessment of the total chemicals in the blood — the metabolome — is necessary,” Anderson said in the release. “In the long-term, we aim to identify a biomarker or a disorder in a chemical pathway that is linked to blood vessel health and subsequent diabetes.”
Disclosure: This work was supported by the National Institute for Health Research Manchester Biomedical Research Centre. One researcher reports funding from a National Institute for Health Research Academic Clinical Lectureship in Cardiology.
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