Circulating metabolites and the development of type 2 diabetes in Chinese adults

Objective To assess prospective associations of circulating metabolites with risk of type 2 diabetes (T2D) among Chinese adults. Research Design and Methods A case-cohort study within the 8-year prospective China Kadoorie Biobank comprised 882 incident cases of T2D and 789 subcohort participants. NMR metabolomic profiling quantified 225 metabolites in stored baseline plasma samples. Cox regression related individual metabolites with T2D risk, adjusting for potential confounders and fasting time. Results After correction for multiple testing, 163 metabolites were significantly associated with risk of T2D (p<0.05). There were strong positive associations of VLDL particle size, the ratio of apolipoprotein B/apolipoprotein A1, branched chain amino acids, glucose and triglycerides with T2D, and inverse associations of HDL-cholesterol, HDL particle size, and relative omega-3 and saturated fatty acid concentrations. Conclusions In Chinese adults, metabolites across diverse pathways were independently associated with T2D risk, providing valuable aetiological insights and potential to improve T2D risk prediction