According to a new study, measuring dozens of different types of fats in the blood can predict the risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) years in the future.
Such early detection using lipidomic profiling could pave the way for dietary and lifestyle changes to be recommended before the disease shows its symptoms.
At the moment, risk assessment for T2D and CVD is mostly based on patient history and current risk behaviors, as well as the levels and ratios of two primary blood lipids, high- and low-density cholesterol. However, the blood includes over a hundred other forms of lipids that are hypothesized to reflect elements of metabolism and equilibrium throughout the body.
To see if a more complete measure of blood lipids could improve risk prediction accuracy, the researchers used data and blood samples from a longitudinal health study of over 4,000 healthy, middle-aged Swedish citizens who were originally examined in 1991 and then tracked until 2015. The amounts of 184 lipids were measured using high-throughput, quantitative mass spectrometry on baseline blood samples. During the study’s follow-up period, 13.8 percent of individuals acquired T2D and 22 percent had CVD.
The authors developed the lipid-based risk profile by doing several training/test cycles on the data, creating a risk model using a randomly chosen two-thirds of the lipid data and then determining if the model successfully predicted risk in the remaining third. After the model was made, people were put into one of six groups based on their lipidomics profile.
The highest-risk group had a 37 percent increased probability of developing type 2 diabetes compared to the group averages, a 168 percent increase in risk. CVD risk was 40.5 percent in the highest-risk group, an increase of 84 percent. The lowest-risk groups also saw big drops in risk compared to the rest of the population. A higher chance of developing either disease was observed regardless of known genetic risk factors or the number of years until disease onset.
These discoveries could have a number of critical ramifications. On an individual level, it may be able to identify risk decades before disease manifestation, allowing for early intervention. Lipidomics may bring fresh insights into when and why disease occurs, either in combination with genetics and patient history or independently. Furthermore, identifying the lipids that contribute the most to risk may lead to the discovery of new therapeutic candidates.
“The lipidomic risk, which is derived from only one single mass-spectrometric measurement that is cheap and fast, could extend traditional risk assessment based on clinical assay,” said the authors.
Individual lipids in blood may also be the result of or contribute to a wide range of metabolic processes, making them potentially useful as indicators of those processes.
If that is true, the authors added, “the lipidome may provide insights much beyond diabetes and cardiovascular disease risk.”
The team said, “Strengthening disease prevention is a global joint effort with many facets. We show how lipidomics can expand our toolkit for early detection of individuals at high risk of developing diabetes and cardiovascular diseases.”
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