Plasma acylcarnitines tied to higher risk of T2D in people at high CV risk
Plasma acylcarnitines, mainly including short- and long-chain acylcarnitines, are a predictor of type 2 diabetes (T2D) in individuals at high cardiovascular risk, according to a study.
Furthermore, including acylcarnitines into the model does not significantly improve T2D prediction C-statistics beyond traditional risk factors, including fasting glucose.
To examine the relationship between baseline and 1-year changes in acylcarnitines and their diabetes predictive ability beyond traditional risk factors, a case-cohort study was designed within the PREDIMED Study including all incident T2D cases (n=251) and randomly selected participants (n=694) at baseline (follow-up, 3.8 years).
A targeted approach by liquid chromatography–tandem mass spectrometry was used to measure plasma acylcarnitines. The investigators used weighted Cox regression models to test the associations between baseline and 1-year changes in individual acylcarnitines and T2D risk. They also used elastic net regressions to select acylcarnitines for T2D prediction and a cross-validation approach to compute a weighted score.
A significant association was found between an acylcarnitine profile and a higher risk of T2D independent of traditional risk factors. For every standard deviation (SD) increment of the predictive model scores, the relative risks of T2D were 4.03 (95 percent CI, 3.00–5.42; p<0.001) for the conventional model and 4.85 (3.65–6.45; p<0.001) for the model including acylcarnitines (hazard ratio attributed to acylcarnitines, 1.33; 1.08–1.63; p<0.001).
The inclusion of acylcarnitines into the model did not significantly improve the area under the receiver operator characteristic curve (0.86–0.88; p=0.61). Furthermore, an association existed between a 1-year increase in C4OH-carnitine and higher T2D risk (per SD increment, 1.44; 1.03–2.01).