Longitudinal Plasma Lipidome and Risk of Type 2 Diabetes in a Large Sample of American Indians With Normal Fasting Glucose: The Strong Heart Family Study
posted on 2021-10-26, 15:43authored byGuanhong Miao, Ying Zhang, Zhiguang Huo, Wenjie Zeng, Jianhui Zhu, Jason G. Umans, Gert Wohlgemuth, Diego Pedrosa, Brian DeFelice, Shelley A. Cole, Amanda M. Fretts, Elisa T. Lee, Barbara V. Howard, Oliver Fiehn, Jinying Zhao
<strong>OBJECTIVE:</strong> Comprehensive
assessment of alterations in lipid species preceding T2D is largely unknown. We
aimed to identify plasma molecular lipids associated with risk of T2D in
American Indians.
<p><strong>RESEARCH
DESIGN AND METHODS</strong>: Using an untargeted LC-MS, we
repeatedly measured 3,907 fasting plasma samples from 1,958 participants who
attended two exams (~5.5 year apart) and were followed up to 16 years in the
Strong Heart Study. Mixed-effect logistic regression was used to identify
lipids associated with risk of T2D adjusting for traditional risk factors. Repeated
measurement analysis was performed to examine the association between change in
lipidome and change in continuous measures of T2D adjusting for baseline
lipids. Multiple testing was controlled by false discovery rate at 0.05.</p>
<p><strong>RESULTS:</strong>
Higher baseline level of 33 lipid species, including TAGs, DAGs, PEs, and PCs, was significantly associated with increased
risk of T2D (odds ratio [OR] per SD increase in log2-transformed baseline
lipids: 1.50-2.85) at 5-year follow-up. Of these, 21 lipids were also
associated with risk of T2D at 16-year follow-up. Aberrant lipid profiles were also
observed in prediabetes (OR per SD increase in log2-transformed baseline lipids:
1.30-2.19 for risk lipids; 0.70-0.78 for protective lipids). Longitudinal changes in 568
lipids were significantly associated with changes in continuous measures of
T2D. Multivariate analysis identified distinct lipidomic signatures differentiating
high from low risk groups. </p>
<p><strong>CONCLUSIONS:</strong> Lipid
dysregulation occurs many
years preceding T2D, and novel molecular lipids (both baseline level and longitudinal
change over time) are significantly associated with risk of T2D beyond traditional
risk factors. Our findings shed light on the mechanisms linking dyslipidemia to T2D and
may yield novel
therapeutic targets for early intervention tailored to American Indians.</p>
Funding
This study was supported by the National Institutes of Health grants R01DK107532. The Strong Heart Study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute, National Institute of Health, Department of Health and Human Services, under contract numbers 75N92019D00027, 75N92019D00028, 75N92019D00029, and 75N92019D00030. The study was previously supported by research grants: R01HL109315, R01HL109301, R01HL109284, R01HL109282, and R01HL109319 and by cooperative agreements: U01HL41642, U01HL41652, U01HL41654, U01HL65520, and U01HL65521.