Different profiles of acylcarnitines were detected comparing cases of obesity, insulin resistance, metabolic syndrome or diabetes with relevant controls. However, it remains to be evaluated whether acylcarnitines are able to identify high-risk individuals for future development of type 2 diabetes.

Research teams led by Professors LIN Xu, WU Jiarui and ZENG Rong at the Shanghai Institutes for Biological Sciences of Chinese Academy of Sciences reported that a panel of acylcarnitines, mainly involving mitochondrial lipid dysregulation, significantly improved predictive ability for type 2 diabetes beyond conventional risk factors. This study entitled “Early Prediction of Developing Type 2 Diabetes by Plasma Acylcarnitines: Population-Based Study” was published online in Diabetes Care.

As a largely preventable disease, early prediction is the key to control the global epidemic trend of type 2 diabetes, which requires identification of novel biomarkers. With the rapid development of advanced metabolomic technology, omics-based biomarkers are expected to be used for earlier prediction of metabolic diseases.

In this population-based prospective study, baseline plasma acylcarnitines were measured by liquid chromatography-tandem mass spectrometry in 2103 community-living Chinese aged 50-70 years from Beijing and Shanghai, and 34 free carnitine and acylcarnitines were detected.

Researchers found that a panel of acylcanitines, especially with long-chain, was significantly associated with increased risk of type 2 diabetes. The panel of acylcanitines is independent of conventional risk factors including body mass index (BMI), fasting glucose, glycohemoglobin (HbA1c) and family history of diabetes.

Moreover, adding selected acylcarnitines substantially improved predictive ability for incident diabetes, as area under the receiver operator characteristic curve improved to 0.89 in full model compared with 0.73 in the conventional model (age, sex, region, residence, smoking, drinking, physical activity, family history of diabetes, BMI, fasting glucose, HbA1c and systolic blood pressure).

The study suggests potential utility of acylcarnitines as novel early predictors in diabetes risk assessment.

To the best of the researchers’ knowledge, the current study was the first study showing acylcarnitines, mainly involving mitochondrial lipid dysregulation, could effectively predict incident diabetes.

This work was supported by the Ministry of Science and Technology of China, National Natural Science Foundation of China, Chinese Academy of Sciences,etc.