It may be possible to predict people who are at a higher risk of developing type 2 diabetes by up to ten years before symptoms appear, by measuring certain molecules in their blood.
Researchers from the Massachusetts General Hospital (MGH) have found that higher levels of five metabolites not only show increased risk of diabetes in the general population, but also determined that people with typical increased risk factors like obesity, were the most likely to develop diabetes.
Lead author Dr Thomas Wang, of the MGH Cardiovascular Research Center (CVRC) and Division of Cardiology in Boston, Massachusetts, said that:
"These findings could provide an insight into the metabolic pathways that are altered very early in the process leading to diabetes."
He said this could mean that those individuals most likely to be at risk could be spotted early and start preventive measures.
Life in all organisms is possible because of metabolism: a series of chemical reactions that do useful things like break down food to provide energy, and supply raw materials like proteins and nucleic acids for making and repairing cells. These cellular processes produce byproducts, called metabolites, which are small molecules that enter the bloodstream. It is these metabolites that are being measured by the researchers.
Metabolism needs steady levels of glucose for the cells to function and have the correct amount of energy, which relies on the hormone insulin. When this goes wrong, diabetes occurs. The research found that it may be possible to predict this up to 10 years in advance by measuring the levels of 5 metabolites, which in this case are, the amino acids isoleucine, leucine, valine, tyrosine and phenylalanine.
The study analysed data from the Framingham Offspring Study which followed 2,400 participants. The first stage of the study measured the baseline levels of 61 metabolites in two groups of participants, 189 who developed diabetes, and another 189 who didn’t but were matched for age, gender, and a range of diabetes risk factors such as obesity, and fasting glucose levels. The findings showed that 5 amino acids were significantly linked to the development of diabetes.
During the second stage of the study the researchers replicated the results of the same amino acids with 326 participants from the Malmo Diet and Cancer Study. They showed that by using a cluster of amino acids compared to studying each individually improved the prediction of risk. Participants from the study were ranked according to their blood levels of three amino acids. From here the researchers found that those ranked in the top quartile were at a five time greater risk of developing diabetes compared with those in the bottom quartile.
The research has shown the potential to identify diabetes in advance, however larger scale investigations are required to assess whether this can be used clinically to identify higher risk individuals.
