Scientists have identified five molecules in the blood that can foretell diabetes risk years before typical signs of the disease appear. The finding might help to identify at-risk people who could take steps to delay or halt the disease.
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Type 2 diabetes, the most common form of the disease, develops gradually over many years. By the time it’s diagnosed, the insulin-producing cells in the pancreas may already be damaged.
Several factors are known to raise the diabetes risk, including excess weight and inactivity. But a more accurate indicator, such as molecular biomarkers in the blood, could lead to more targeted interventions.
Thomas J. Wang, M.D., and Robert E. Gerszten, M.D., and their colleagues at Massachusetts General Hospital and Boston University analyzed blood samples gathered as part of the Framingham Offspring Study, a long-term community-based study sponsored by NIH’s National Heart, Lung and Blood Institute (NHLBI). The new analysis was funded in part by NIDDK. The results were reported in a 2011 edition of Nature Medicine.
Of more than 2,400 participants with no signs of diabetes in the early 1990s, about 200 developed type 2 diabetes during the 12 years of follow-up.
The original blood samples from this latter group were analyzed and compared to samples from age-matched participants who didn’t develop diabetes but had similar risk factors.
The scientists used an approach called metabolomics, which focuses on the unique mix of chemicals, called metabolites, substances left behind from bodily reactions. These chemical fingerprints can provide clues to health.
Using new technologies to rapidly measure the levels of 61 amino acids and other metabolites in blood samples, the researchers found that elevated levels of five amino acids – isoleucine, leucine, valine, tyrosine and phenylalanine – seemed to predict a diagnosis of diabetes.
High levels of these amino acids were detected as early as 12 years before onset of disease. Further analysis showed that a combination of three amino acids was an even better predictor of diabetes risk.
The scientists confirmed their results by analyzing blood samples from more than 300 participants in an independent study of cancer and diet.
Even in participants closely matched for traditional diabetes risk factors, such as obesity, these amino acid levels could help differentiate people at greatest risk.
Participants with the highest levels of the three most predictive amino acids were 4-5 times more likely to develop diabetes than those with the lowest levels.
“These findings could provide insight into metabolic pathways that are altered very early in the process leading to diabetes,” Wang says. “They also raise the possibility that, in selected individuals, these measurements could identify those at highest risk of developing diabetes so that early preventive measures could be instituted.”
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