Obesity is associated with the risk of developing type-2 diabetes, nonalcoholic fatty liver disease, cardiovascular disease and cancer. However, it has been increasingly recognized that obesity is not a homogeneous condition and about 25 to 40 percent of obese individuals can actually maintain healthy status with no apparent signs of health complications.
Currently, there are no clinical tests that can tell if a person has a likelihood of developing diabetes, this added to the fact that a person can be a ‘healthy obese’ makes pre-diabetes extremely difficult to detect, if at all. Now, researchers from the University of Hawai’i and Shanghai Jiao Tong University have identified a panel of markers that helps identify if a person is pre-diabetic by measuring the fatty acids in their blood. The team state that the levels of these fatty acids can change up to 10 years before the individuals are diagnosed with diabetes. The opensource study is published in the journal EBioMedicine.
Previous studies show when nutrient intake exceeds expenditure, tissues such as adipose, liver, and skeletal become saturated with lipids, resulting in increased lipid export, leading to elevated plasma free fatty acids (FFAs). Research suggests that individuals with higher plasma concentrations of FFAs are at increased risk for type-2 diabetes. Normalizing plasma FFA levels has also been proposed as a novel therapeutic approach for obesity and metabolic diseases. As plasma FFA levels are chronically elevated in obese individuals the group hypothesized that increased FFA levels must be an important feature of obesity-associated metabolic syndrome as well as cardiovascular disease. The current study identified markers through a blood sample test that may help predict the risk of developing pre-diabetes and metabolic syndrome, which is a group of conditions including elevated blood pressure, insulin resistance and high glucose level.
The current study used metabolomics to study four independent cohorts that involved a total of 452 participants. The lab performed a cross-sectional study with metabolically healthy and unhealthy obese subjects, a longitudinal study to observe the occurrence of developing pre-diabetes over as long as ten years, and two studies to evaluate the therapeutic effects on subjects who underwent metabolic surgery or received very low carbohydrate diet for eight weeks.
Data findings show that FFA levels were significantly elevated in overweight/obese subjects with diabetes compared to their healthy counterparts. The group identified a group of unsaturated fatty acids (UFAs) that are closely correlated with metabolic status in two groups of obese individuals who underwent weight loss intervention and can predict the recurrence of diabetes at two years after metabolic surgery. Results show that two UFAs, dihomo-gamma-linolenic acid and palmitoleic acid, were also able to predict the future development of metabolic syndrome (MS) in a group of obese subjects. The group state that the unsaturated fatty acid markers can indicate if someone is pre-diabetic long before conventional ways of measuring the disease.
The team surmise that their findings could allow the medical team to warn patients years before the onset of diabetes allowing them to change their lifestyle patterns. For the future, the researchers aim to continue developing the blood test technology, eventually making it available for the clinic.