BLOOD BIOMARKERS AND RISK OF INCIDENT TYPE 2 DIABETES

Abstract

The current thesis evaluated the predictive utility of multiple biomarkers that operate in the causal pathways of T2D development. We measured plasma triglyceride (TG), HDL cholesterol, alanine transaminase (ALT), high-sensitivity C-reactive protein, ferritin, adiponectin, fetuin-A and retinol-binding protein 4 in a case-control study comprising 485 T2D cases and 485 matched controls nested within the prospective Singapore Chinese Health Study cohort. We constructed a weighted biomarker score based on the strength of associations of these biomarkers with T2D. As a result, we found that a score comprising TG-to-HDL ratio, ALT, ferritin and adiponectin was associated with an approximately 12-fold increased T2D risk when comparing the extreme quartiles of the score. Moreover, the biomarker score improved T2D prediction on top of existing clinical risk factors such as body mass index and glucose parameters. Thus, combining multiple biomarkers may enhance the ability to identify people with future risk of developing T2D.