The impact of the UCP2 ؊866G>A and UCP3 ؊55C>T variants on prospective risk of type 2 diabetes was examined over 15 years in 2,936 healthy middle-aged men (mean age 56 years). Conversion to diabetes (n ؍ 169) was associated with higher BMI, blood pressure, cholesterol, triglycerides and C-reactive protein. T he rate of mitochondrial oxidative metabolism appears to be important in the development of type 2 diabetes with reduced expression of key genes in oxidative metabolism and mitochondrial function, not only in patients with type 2 diabetes (1) but also in subjects with pre-diabetes, even when glucose tolerance is normal (2). Fuel substrate oxidation, via the respiratory chain, leads to development of a proton gradient across the mitochondrial membrane, which can be dissipated to produce ATP. This gradient can also be dissipated without the production of ATP by uncoupled metabolism, with the release of energy as heat. Therefore, the rate of oxidative metabolism depends not only on ATP requirements but also the extent to which uncoupled fuel substrate oxidation is present (3).Uncoupling protein (UCP)2 and UCP3 are members of a mitochondrial carrier protein superfamily that can facilitate the exchange of substrates across the mitochondrial inner membrane. They show high (ϳ55%) amino acid homology with UCP1 (4), the first in the family to be identified, which occurs in brown adipose tissue. UCP1 plays an important role in nonshivering thermogenesis (5), dissipating the proton gradient by proton transfer across the mitochondrial membrane with the release of heat. The uncoupling of metabolism per se also causes an increase in glycolysis and GLUT4 synthesis and translocation, as well as increased breakdown of fatty acids. This leads to reduced blood glucose and fat mass and improved glucose tolerance (6). The UCP2 and UCP3 genes are located within 8 kb of each other on chromosome 11q13 (7), and the reported association of obesity and diabetes traits (8 -13) with variation in the UCP2-UCP3 gene cluster suggests the importance of this locus in determining risk of these disorders.A substantial role for UCP2 or UCP3 in thermogenesis in humans is unlikely because these proteins are not upregulated by cold, and it has been suggested that the main function of UCP2 is protection from damage caused by reactive oxygen species (ROS) or oxidative stress (14,15). The production of ROS depends, in part, on mitochondrial membrane potential, and reduction of this potential by uncoupling reduces ROS production. In pancreatic -cells, uncoupling by UCP2 has a further effect on glucosestimulated insulin secretion. A reduction in insulin secretion is seen when UCP2 is overexpressed in isolated rat islet cells or human insulinoma cells, and glucose-stimulated insulin secretion is improved in the UCP2 knockout mouse (15). A common variant in the promoter (Ϫ866GϾA, rs659366) is associated with higher UCP2 mRNA levels and was associated with reduced insulin secretion or type 2 diabetes in Austrian (16), Italian (17), and Japanese samples...