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Type 2 diabetes, or T2D, , with cases rising even in children and adolescents. This highlights the need for biomarkers that detect T2D at its earliest stages. T2D is commonly diagnosed after clinical symptoms appear, but detecting and treating T2D earlier can help prevent progression.

In T2D, the body cannot use insulin effectively, leading to high blood sugar levels. Among promising biomarker candidates are branched fatty acid hydroxy fatty acids, or FAHFAs. FAHFAs are bioactive and strongly correlate with insulin sensitivity. In human serum, two of the most abundant FAHFAs are palmitic acid hydroxy stearic acids, or PAHSAs, and palmitic acid hydroxy oleic acids, or PAHOAs. PAHSAs are also antidiabetic and anti-inflammatory.

In a in the Journal of Lipid Research, Ismail Syed and colleagues at the Beth Israel Deaconess Medical Center, University of California, San Diego, and University of Gothenburg investigated whether PAHSAs and PAHOAs could predict worsening glucose tolerance in nondiabetic, first-degree relatives of people with T2D. They found no change in PAHSA or PAHOA levels in participants with normal glucose tolerance. But, in participants who developed impaired glucose tolerance, most PAHSAs decreased, and some PAHOAs increased.

The results suggest that lower PAHSA and higher PAHOA levels may predict worsening glucose tolerance, independent of fasting glucose, insulin, BMI or body fat. In turn, these FAHFAs could serve as biomarkers to detect increased T2D risk in a wide range of individuals. Future studies include determining whether PAHSA levels directly correlate with T2D development.