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Diabetes Type 2 Risk in Obese Patients Seen in Metabolic Biomarkers

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Diabetes Type 2 Risk in Obese Patients Seen in Metabolic Biomarkers
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A research effort comprising four independent studies discovered two unsaturated fatty acids that can be predictive of future diabetes risk, and revealed the importance of unsaturated fatty acids in the development of metabolic syndrome. The research paper, entitled “Circulating Unsaturated Fatty Acids Delineate the Metabolic Status of Obese Individuals,” was published in the journal EbioMedicine.

To provide more personalized treatment and earlier risk assessment so that patients can change possibly damaging lifestyles, there is a need for metabolic tests capable of predicting future health. Such tests might also be relevant in determining the likelihood of metabolic surgery success.

Obesity is a known risk factor for type 2 diabetes (T2D) and other conditions, such as cardiovascular disease and nonalcoholic fatty liver disease, but the population of obese patients is not metabolically homogenous, with 25% to 40% of these patients maintaining healthy profiles. In obese patients, simple tests such as body mass index (BMI) are not predictive of future metabolic disease.

High levels of free fatty acids (FFAs) have been linked, in previous studies, to an increased risk of insulin resistance and T2D. Researchers here investigated the association of FFAs to specific metabolic phenotypes in obesity, and the possible link between specific groups of FFAs and diabetes development.

Dr. Wei Jia, director of the University of Hawaii Cancer Center’s Metabolomics Shared Resources Program, explained in a press release the rationale behind the study, “Currently there are no clinical tests that tell you the likelihood of developing diabetes, only exams that tell you for example if someone that is pre-diabetic has relatively high blood sugar or insulin levels. To know if you are likely to get diabetes in a few years is an important discovery. People can hopefully get tested for the disease during physical exams in the future.”

The research comprised four studies that included samples from a total of 452 patients, where a targeted metabolomics approach was used to measure 40 types of plasma FFAs. One study compared normal weight, obese and T2D patients’ metabolic profiles, while a second study focused on a 10-year prediction of healthy individuals to unhealthy profiles. The other two studies involved therapeutic intervention, dietary intervention, and metabolic surgery, and focused on the change in FFA profiles following these interventions.

Results showed that FFA levels are significantly elevated in overweight and obese subjects with diabetes, compared to healthy controls. Moreover, analysis of metabolic profiles allowed researchers to identify two unsaturated fatty acids, dihomo-gamma-linolenic acid and palmitoleic acid, which can predict the development of metabolic syndrome and T2D in obese patients. A larger group of unsaturated fatty acids was also found to be predictive of recurrence of diabetes in obese patients at two years after metabolic surgery.

Future research planned by the team includes the development of a blood test based on the findings, potentially providing clinicians a means to predict the future health of their patients.

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