Blood Biomarker Predicts Type 2 Diabetes Up to 19 Years Before Onset of Disease

A large study has identified a protein in the blood that could predict type 2 diabetes up to 19 years before the onset of the disease.

This discovery was based on studies led by Lund University (Lund, Sweden) that followed 5,318 people over the course of 4 to 19 years in two different locations in Sweden and Finland. Type 2 diabetes is a growing global epidemic, with 6% of the world population suffering from the disease. However, the risk of developing type 2 diabetes can be greatly reduced by weight control, eating well and exercising before the actual manifestation of the disease. Early detection of type 2 diabetes risk before symptoms could help minimize health complications related to diabetes.

Follistatin is a protein that is mainly secreted from the liver and involved in the regulation of metabolism. The study investigated what happens to the body when follistatin in the blood circulation becomes too high. Using clinical data from the German Tübingen Diabetes Family Study and cell biology investigation, the researchers found that follistatin promotes fat breakdown from the adipose tissue, resulting in increased lipid accumulation in the liver. This in turn increases the risk of nonalcoholic fatty liver disease and type 2 diabetes.

To find out what regulates blood follistatin levels, the researchers performed genome-wide association study (GWAS) on 5,124 people from Sweden, the UK and Italy, and revealed that follistatin levels are genetically regulated by glucokinase regulatory protein (GCKR), which impact on several metabolic traits. The next step is to put the results into clinical use. An AI-based diagnostic tool using follistatin as a biomarker for type 2 diabetes is currently being developed. The tool aims to provide a simple blood test, where results from a protein biomarker panel can be imputed in an AI-driven algorithm, and ultimately give patients a risk score to assess their risk of future type 2 diabetes.

“This study shows that follistatin has the potential to become an important biomarker to predict future type 2 diabetes, and it also brings us one step closer to the understanding of the mechanisms behind the disease”, said Dr. Yang De Marinis, associate professor at Lund University and lead author of the study. “This discovery holds the opportunity of instituting measures to prevent type 2 diabetes from becoming established. Our research will continue towards this goal.”

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