Puukka, K. | bioRxiv Science

bioRxiv2019

Circulating metabolites and the risk of type 2 diabetes: a prospective study of 11,896 young adults from four Finnish cohorts

ObjectiveAdvances in metabolomics now allow high-throughput biomarker profiling of large population studies. We aimed to identify circulating metabolic biomarkers predictive of type 2 diabetes in young adults.\n\nMethodsNuclear magnetic resonance metabolomics was used to quantify 229 metabolic measures in 11,896 individuals from four Finnish cohorts (mean age 33 years, range 24-45). Associations between baseline metabolites and risk of type 2 diabetes onset during 8-15 years of follow-up (392 incident cases) were assessed by logistic regression adjusted for sex, age, body mass index, and fasting glucose.\n\nResultsOut of 229 metabolic measures, 113 were associated with incident diabetes in meta-analysis of the four cohorts (P<0.0009; odds ratios per 1-SD: 0.59-1.50). Among the strongest predictors of diabetes risk were branched-chained and aromatic amino acids (odds ratios 1.31-1.33), triglyceride fractions within the largest very-low-density lipoprotein particles (VLDL; odds ratios 1.33-1.50)), as well as linoleic omega-6 fatty acids (odds ratio 0.75) and free cholesterol in large high-density lipoprotein particles (HDL; odds ratio 0.59). A biomarker score comprised of phenylalanine, free cholesterol in large HDL, and the ratio of cholesteryl esters to total lipids in large VLDL was predictive of the risk for future diabetes in an independent validation cohort (odds ratio 10.1 [95% confidence intervals 4.2-24.1] comparing individuals in upper vs lower fifth of biomarker score). Adjustment for routine lipids and insulin attenuated the odds ratio to 5.8 [2.2-15.1].\n\nConclusionsMetabolic aberrations across multiple molecular pathways are predictive of the long-term risk of type 2 diabetes in young adults. Comprehensive metabolic profiling may potentially help targeting preventive interventions for young asymptomatic individuals at increased risk for type 2 diabetes.

epidemiology↗

bioRxiv2018

Lower hemoglobin levels associate with lower body mass index and healthier metabolic profile

Hemoglobin (Hb) is the main carrier of oxygen. In general, high-end Hb levels within the normal range are considered beneficial for health1. However, activation of the hypoxia response has been shown to protect mice against metabolic dysfunction2-4. We used Hb levels as an indicator for oxygenation status and studied its association with >170 anthropometric and metabolic parameters in two Finnish birth cohorts both in cross-sectional and longitudinal design (max n = 7,175). Here we show a positive linear association between Hb levels and body mass index (BMI). Subjects with the lower Hb levels had better glucose tolerance, lower cholesterol and blood pressure levels, less adverse metabolite profiles and lower inflammatory load. Notably, these associations were not only mediated by the lower BMI, and the effect size of many of them increased with age. Polygenic risk score (PRS) analyses indicated shared genetic determinants between Hb levels and BMI, insulin, triglyceride and HDL cholesterol levels. Mendelian randomization (MR) analyses could not demonstrate causal relationships between Hb and metabolic parameters. However, manipulation of Hb levels by venesection in mice showed evidence for causal associations with body weight and metabolic parameters. Our findings suggest that lower-end normal Hb levels may be favorable for systemic metabolism involving mild chronic activation of the hypoxia response. Therefore modulation of Hb levels could be a novel strategy towards maintenance of metabolic health.

epidemiology↗