Aims/hypothesis: We aimed to evaluate metabolic biomarkers in relation to incident type 2 diabetes (T2D) representing three major ethnic groups in Asia (Chinese, Malay, and Indian) and a European population.
Methods: We used data from male and female adult participants of multiple cohorts, including two cohorts from Singapore (n = 6,393 Asians) consisting of ethnic Chinese, Malays, and Indians, and three cohorts of European-origin participants from Finland (n = 14,558). We used nuclear magnetic resonance to quantify 154 metabolic biomarkers in plasma collected at baseline and performed multivariable logistic regression to assess associations between the metabolic measures and risk of T2D with adjustments for age, sex, BMI and either fasting glucose or glycated haemoglobin (HbA1c).
Results: Of 154 metabolic biomarkers, 59 were associated with higher risk of T2D in both Asians and Europeans (P < 0.0003; Bonferroni-corrected). These included branched-chain and aromatic amino acids and alanine, the inflammatory marker glycoprotein acetyls, total fatty acids, the proportion of monounsaturated fatty acids, apolipoprotein B, larger very low-density lipoprotein particle sizes, and triglycerides. A further 13 metabolic biomarkers were associated with lower T2D risk in both populations including proportion of omega-6 polyunsaturated fatty acids and larger high-density lipoprotein particle sizes. Associations were consistent within the Asian ethnic groups (Phet ≥ 0.05 for all 154 metabolic biomarkers) and largely consistent with the European population (Phet ≥ 0.05 for 128 of 154 metabolic biomarkers).
Conclusions/interpretation: Metabolic biomarkers across a variety of biological pathways were consistently associated with T2D risk in three Asian ethnic groups and a European population.