Indolepropionic acid and novel lipid metabolites are associated with a lower risk of type 2 diabetes in the Finnish Diabetes Prevention Study

Wide-scale profiling technologies including metabolomics broaden the possibility of novel discoveries related to the pathogenesis of type 2 diabetes (T2D). By applying non-targeted metabolomics approach, we investigated here whether serum metabolite profile predicts T2D in a well-characterized study population with impaired glucose tolerance by examining two groups of individuals who took part in the Finnish Diabetes Prevention Study (DPS); those who either early developed T2D (n = 96) or did not convert to T2D within the 15-year follow-up (n = 104). Several novel metabolites were associated with lower likelihood of developing T2D, including indole and lipid related metabolites. Higher indolepropionic acid was associated with reduced likelihood of T2D in the DPS. Interestingly, in those who remained free of T2D, indolepropionic acid and various lipid species were associated with better insulin secretion and sensitivity, respectively. Furthermore, these metabolites were negatively correlated with low-grade inflammation. We replicated the association between indolepropionic acid and T2D risk in one Finnish and one Swedish population. We suggest that indolepropionic acid, a gut microbiota-produced metabolite, is a potential biomarker for the development of T2D that may mediate its protective effect by preservation of β-cell function. Novel lipid metabolites associated with T2D may exert their effects partly through enhancing insulin sensitivity.

[1]  F. Knop,et al.  Bile Acid Sequestrants: Glucose-Lowering Mechanisms and Efficacy in Type 2 Diabetes , 2014, Current Diabetes Reports.

[2]  P. Hylemon,et al.  Bile acids and the gut microbiome , 2014, Current opinion in gastroenterology.

[3]  W. R. Wikoff,et al.  Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites , 2009, Proceedings of the National Academy of Sciences.

[4]  Christian Gieger,et al.  Biomarkers for Type 2 Diabetes and Impaired Fasting Glucose Using a Nontargeted Metabolomics Approach , 2013, Diabetes.

[5]  M. Laakso,et al.  Insulin Secretion and Its Determinants in the Progression of Impaired Glucose Tolerance to Type 2 Diabetes in Impaired Glucose-Tolerant Individuals The Finnish Diabetes Prevention Study , 2012 .

[6]  R. Landberg,et al.  Determination of alkylresorcinols and their metabolites in biological samples by gas chromatography-mass spectrometry. , 2015, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[7]  Jussi Paananen,et al.  Nontargeted metabolite profiling discriminates diet-specific biomarkers for consumption of whole grains, fatty fish, and bilberries in a randomized controlled trial. , 2015, The Journal of nutrition.

[8]  B. Poeggeler,et al.  Potent Neuroprotective Properties against the Alzheimer β-Amyloid by an Endogenous Melatonin-related Indole Structure, Indole-3-propionic Acid* , 1999, The Journal of Biological Chemistry.

[9]  Sandhya Kortagere,et al.  Symbiotic Bacterial Metabolites Regulate Gastrointestinal Barrier Function via the Xenobiotic Sensor PXR and Toll‐like Receptor 4 , 2014, Immunity.

[10]  L. Weinehall,et al.  How to diagnose and classify diabetes in primary health care: Lessons learned from the Diabetes Register in Northern Sweden (DiabNorth) , 2012, Scandinavian journal of primary health care.

[11]  S. Turroni,et al.  High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome , 2015, Gut.

[12]  U. Meyer,et al.  Amylin at the interface between metabolic and neurodegenerative disorders , 2015, Front. Neurosci..

[13]  R. Reiter,et al.  Indole‐3‐propionic acid, a melatonin‐related molecule, protects hepatic microsomal membranes from iron‐induced oxidative damage: Relevance to cancer reduction , 2001, Journal of cellular biochemistry.

[14]  K. Park,et al.  Lysophosphatidylcholine Activates Adipocyte Glucose Uptake and Lowers Blood Glucose Levels in Murine Models of Diabetes* , 2009, The Journal of Biological Chemistry.

[15]  James Kinross,et al.  The gut microbiota and host health: a new clinical frontier , 2015, Gut.

[16]  G. Macfarlane,et al.  Enumeration of human colonic bacteria producing phenolic and indolic compounds: effects of pH, carbohydrate availability and retention time on dissimilatory aromatic amino acid metabolism. , 1996, The Journal of applied bacteriology.

[17]  M. Laakso,et al.  Plasma fatty acids as predictors of glycaemia and type 2 diabetes , 2015, Diabetologia.

[18]  A. Peters,et al.  Identification of Serum Metabolites Associated With Risk of Type 2 Diabetes Using a Targeted Metabolomic Approach , 2013, Diabetes.

[19]  Thomas J. Wang,et al.  Metabolite Traits and Genetic Risk Provide Complementary Information for the Prediction of Future Type 2 Diabetes , 2014, Diabetes Care.

[20]  R. Abagyan,et al.  XCMS: processing mass spectrometry data for metabolite profiling using nonlinear peak alignment, matching, and identification. , 2006, Analytical chemistry.

[21]  Christian Gieger,et al.  Novel biomarkers for pre-diabetes identified by metabolomics , 2012, Molecular systems biology.

[22]  Dolores Corella,et al.  Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease. , 2015, The American journal of clinical nutrition.

[23]  Chenxiao Liu,et al.  Adiponectin, TNF-α and inflammatory cytokines and risk of type 2 diabetes: A systematic review and meta-analysis. , 2016, Cytokine.

[24]  M. Laakso,et al.  Insulin Secretion and Its Determinants in the Progression of Impaired Glucose Tolerance to Type 2 Diabetes in Impaired Glucose-Tolerant Individuals , 2012, Diabetes Care.

[25]  Johanna Kuusisto,et al.  Changes in Insulin Sensitivity and Insulin Release in Relation to Glycemia and Glucose Tolerance in 6,414 Finnish Men , 2009, Diabetes.

[26]  V. Mootha,et al.  Metabolite profiles and the risk of developing diabetes , 2011, Nature Medicine.

[27]  Patrice D Cani,et al.  Involvement of gut microbiota in the development of low-grade inflammation and type 2 diabetes associated with obesity , 2012, Gut microbes.

[28]  U. Keyser,et al.  Bacterial Metabolite Indole Modulates Incretin Secretion from Intestinal Enteroendocrine L Cells , 2014, Cell reports.

[29]  D. Gevers,et al.  The Gut Microbiome Contributes to a Substantial Proportion of the Variation in Blood Lipids , 2015, Circulation research.

[30]  D. Accili,et al.  Human Insulin Resistance Is Associated With Increased Plasma Levels of 12α-Hydroxylated Bile Acids , 2013, Diabetes.

[31]  Terho Lehtimäki,et al.  Branched-Chain and Aromatic Amino Acids Are Predictors of Insulin Resistance in Young Adults , 2013, Diabetes Care.

[32]  A. Koulman,et al.  A Review of Odd-Chain Fatty Acid Metabolism and the Role of Pentadecanoic Acid (C15:0) and Heptadecanoic Acid (C17:0) in Health and Disease , 2015, Molecules.

[33]  Lin Shi,et al.  Large-scale untargeted LC-MS metabolomics data correction using between-batch feature alignment and cluster-based within-batch signal intensity drift correction , 2016, Metabolomics.

[34]  E. Oetjen Incretin Effects on β-Cell Function, Replication, and Mass: The human perspective , 2012 .

[35]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[36]  A. Garber Incretin Effects on β-Cell Function, Replication, and Mass , 2011, Diabetes Care.

[37]  H. Matsushime,et al.  Lysophosphatidylcholine enhances glucose-dependent insulin secretion via an orphan G-protein-coupled receptor. , 2005, Biochemical and biophysical research communications.

[38]  A. Jaudszus,et al.  Pentadecanoic and Heptadecanoic Acids: Multifaceted Odd-Chain Fatty Acids. , 2016, Advances in nutrition.

[39]  G. Hallmans,et al.  Long-term reproducibility of plasma alkylresorcinols as biomarkers of whole-grain wheat and rye intake within Northern Sweden Health and Disease Study Cohort , 2013, European Journal of Clinical Nutrition.

[40]  C. Ling,et al.  β-Cell Failure in Type 2 Diabetes: Postulated Mechanisms and Prospects for Prevention and Treatment , 2014, Diabetes Care.

[41]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[42]  Choon Nam Ong,et al.  Metabolic signature shift in type 2 diabetes mellitus revealed by mass spectrometry-based metabolomics. , 2013, The Journal of clinical endocrinology and metabolism.

[43]  F. Knop,et al.  Bile acid sequestrants in type 2 diabetes: potential effects on GLP1 secretion. , 2014, European journal of endocrinology.

[44]  G. Macfarlane,et al.  Formation of Phenolic and Indolic Compounds by Anaerobic Bacteria in the Human Large Intestine , 1997, Microbial Ecology.

[45]  N. Abumrad,et al.  Bile diversion to the distal small intestine has comparable metabolic benefits to bariatric surgery , 2015, Nature Communications.

[46]  E. Feskens,et al.  Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies , 2015, Diabetologia.

[47]  M. Schulze,et al.  Amino acids, lipid metabolites, and ferritin as potential mediators linking red meat consumption to type 2 diabetes. , 2015, American Journal of Clinical Nutrition.

[48]  Qiang Feng,et al.  A metagenome-wide association study of gut microbiota in type 2 diabetes , 2012, Nature.

[49]  P. Bork,et al.  Human gut microbes impact host serum metabolome and insulin sensitivity , 2016, Nature.

[50]  W. D. de Vos,et al.  Associations between the human intestinal microbiota, Lactobacillus rhamnosus GG and serum lipids indicated by integrated analysis of high-throughput profiling data , 2013, PeerJ.

[51]  J. Eriksson,et al.  Markers of cholesterol metabolism as biomarkers in predicting diabetes in the Finnish Diabetes Prevention Study. , 2015, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[52]  T. Lehtimäki,et al.  Circulating Metabolite Predictors of Glycemia in Middle-Aged Men and Women , 2012, Diabetes Care.

[53]  C. Burt,et al.  The Human Perspective , 2015, Perspectives in biology and medicine.

[54]  F. Tinahones,et al.  Two Healthy Diets Modulate Gut Microbial Community Improving Insulin Sensitivity in a Human Obese Population. , 2016, The Journal of clinical endocrinology and metabolism.

[55]  T. Valle,et al.  The Finnish Diabetes Prevention Study , 2000, British Journal of Nutrition.

[56]  Adam Kowalczyk,et al.  Plasma Lipid Profiling Shows Similar Associations with Prediabetes and Type 2 Diabetes , 2013, PloS one.

[57]  S. Aunola,et al.  Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS) , 2013, Diabetologia.