Biomarkers of food intake and nutrient status are associated with glucose tolerance status and development of type 2 diabetes in older Swedish women

• Published in: The American journal of clinical nutrition Vol. 106; no. 5; pp. 1302 - 1310
• Main Authors: Savolainen, Otto, Lind, Mads Vendelbo, Bergström, Göran, Fagerberg, Björn, Sandberg, Ann-Sofie, Ross, Alastair
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017; American Society for Clinical Nutrition, Inc
• Subjects: Alanine; alkylresorcinols; alpha-tocopherol; alpha-Tocopherol - analysis; analysis of covariance; beef; beta-alanine; beta-Alanine - analysis; Biomarkers; Biomarkers - analysis; Cardiovascular diseases; Case-Control Studies; Cholesterol - blood; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diet; Dietary intake; dietary markers; Disease prevention; Eicosapentaenoic acid; Eicosapentaenoic Acid - analysis; Endocrinology and Diabetes; Endokrinologi och diabetes; Female; Fish; follow-up; Follow-Up Studies; Food intake; Furans - analysis; Glucose; Glucose Intolerance; Glucose tolerance; Grain; Health risks; healthy diet; Humans; insulin sensitivity; life-style; Linoleic acid; Logistic Models; Margarine; mass-spectrometry; meat consumption; metabolome; Metabolomics; Middle Aged; noninsulin-dependent diabetes mellitus; Nutrient status; nutrition; Nutrition & Dietetics; Oils & fats; Oleic acid; plasma alkylresorcinols; prediabetes; prevention program outcomes; Propionates - analysis; Prospective Studies; Regression analysis; Resorcinols - analysis; Risk analysis; Risk Factors; Rye; rye intake; Sweden; Tocopherol; Triglycerides - blood; vegetable oil; Vegetable oils; Vitamin E; Wheat; whole grain foods; whole-grain intake; women; prediabetes; biomarkers; GTS; T2D; MRM; IFG; CVD; nutrition; metabolomics; IGT; NGT; diet; GC-MS/MS; metabolome; CMPF
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.3945/ajcn.117.152850

Diet is frequently associated with both the development and prevention of type 2 diabetes (T2D), but there is a lack of objective tools for assessing the relation between diet and T2D. Biomarkers of dietary intake are unconfounded by recall and reporting bias, and using multiple dietary biomarkers could help strengthen the link between a healthy diet and the prevention of T2D. The objective of this study was to explore how diet is related to glucose tolerance status (GTS) and to future development of T2D irrespective of common T2D and cardiovascular disease risk factors by using multiple dietary biomarkers. Dietary biomarkers were measured in plasma from 64-y-old Swedish women with different GTS [normal glucose tolerance (NGT; n = 190), impaired glucose tolerance (IGT; n = 209), and diabetes (n = 230)]. The same subjects were followed up after 5 y to determine changes in glucose tolerance (n = 167 for NGT, n = 174 for IGT, and n = 159 for diabetes). ANCOVA and logistic regression were used to explore baseline data for associations between dietary biomarkers, GTS, and new T2D cases at follow-up (n = 69). Of the 10 dietary biomarkers analyzed, β-alanine (beef) (P-raw < 0.001), alkylresorcinols C17 and C19 (whole-grain wheat and rye) (P-raw = 0.003 and 0.011), eicosapentaenoic acid (fish) (P-raw = 0.041), 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) (fish) (P-raw = 0.002), linoleic acid (P-raw < 0.001), oleic acid (P-raw = 0.003), and α-tocopherol (margarine and vegetable oil) (P-raw < 0.001) were associated with GTS, and CMPF (fish) (OR: 0.72; 95% CI: 0.56, 0.93; P-raw = 0.013) and α-tocopherol (OR: 0.71; 95% CI: 0.51, 0.98; P-raw = 0.041) were inversely associated with future T2D development. Several circulating dietary biomarkers were strongly associated with GTS after correction for known T2D risk factors, underlining the role of diet in the development and prevention of T2D. To our knowledge, this study is the first to use multiple dietary biomarkers to investigate the link between diet and disease risk.