Obesity is by far the most common risk factor for type 2 diabetes, but one in five people diagnosed with the disease are of a normal weight. A new test promises a novel way to estimate diabetes risk by looking for patterns of molecules in blood samples that correspond with obesity-related metabolic changes, regardless of a person’s actual weight.
Obesity has been associated with a massively heightened risk of developing type 2 diabetes. And one of the most effective ways to prevent, or even reverse, type 2 diabetes is by dropping the pounds.
So, for doctors keeping tracking of a patient’s health, measuring body-mass index (BMI) can be extraordinarily useful in determining whether someone has any underlying metabolic problems. However, 20 percent of those diagnosed with type 2 diabetes are of a normal weight, and catching those patients in prediabetic stages can be challenging.
The new research, from scientists at Sweden’s Lund University, set out to investigate whether levels of certain metabolites in blood samples correspond with a person’s BMI and whether those obese-linked metabolic patterns can be found in people with a normal body mass index.
The study first tracked 108 specific metabolites in blood samples from more than 7,000 people. Patterns of these metabolites could effectively predict a person’s BMI but, interestingly, a small number of people with normal BMI displayed the same metabolite profiles as the obese subjects.
The researchers then created five different groups under the umbrella of metabolic BMI. For most people their metabolic BMI effectively matches their traditional BMI but one group was found with a metabolic BMI around five units higher than their traditional BMI.
To assess whether this metabolic BMI profile could be linked to disease the researchers turned to data from a long-running project called the Malmö Diet and Cancer study. That project tracked more than 50,000 people for over 10 years, primarily investigating the impact of diet on cancer.
Using this novel metabolic BMI profile the researchers assessed patient records from that long cohort study. The findings revealed those subjects with a normal weight but high metabolic BMI were twice as likely to develop type 2 diabetes compared to those whose metabolic BMI was in sync with their physical BMI.
Filip Ottosson, corresponding author on the new study, said this metabolic BMI test could be used to identify those patients with hidden metabolic problems. Although weight management is the most common first-line treatment for prediabetes and type 2 diabetes, other lifestyle interventions may be helpful in this group.
"This could become a new method for screening for type 2 diabetes and for initiating preventive measures for people of normal weight who are at high risk of developing the disease,” said Ottosson. “Weight loss strategies will not benefit this group, which seemingly requires alternative interventions. In the long-term perspective, we may develop drugs that would lower the levels of some of the metabolites.”
The new study was published in the journal Diabetes Care.
Source: Lund University
