Patients who had lipidome profiles including triacylglycerols, diacylglycerols, and phosphatidylethanolamines were at a higher risk of developing type 2 diabetes (T2D) than patients with lipidome profiles including lysophospholipids, phosphatidylcholine-plasmalogens, sphingomyelins, and cholesterol esters, according to results from a case-cohort study published in Diabetes Care.

Researchers analyzed a subcohort of the Prevención con Dieta Mediterránea (PREDIMED) trial to study the lipidome profiles associated with T2D and determine whether dietary changes altered lipidome profiles and subsequent risk for T2D.

Patients who were at high risk for cardiovascular disease were randomly assigned to 1 of 3 intervention groups: a Mediterranean diet supplemented with extra virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a low-fat control diet. All patients were assessed at baseline and at yearly follow-ups with lifestyle and activity questionnaires and edetate disodium plasma samples.

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By the end of the study, 250 patients developed T2D. Researchers compared this group with 692 participants who had not developed T2D. At baseline, participants who developed diabetes were more often male, more current smokers, and had a mean fasting glucose concentration of 117 mg/dL.

Lysophosphatidylcholines, lysophosphatidylethanolamines, phosphatidylcholine-plasmalogens, sphingomyelins, and cholesterol esters were more often recorded in profiles not associated with the development of T2D (P ≤.001, for all) and triacylglycerols, diacylglycerols, and phosphatidylethanolamines were more common in profiles associated with T2D (P <.001, P <.001, and P =.001, respectively). After 1 year of dietary intervention, all associations remained similar to those observed at baseline. Changes in short triacylglycerol score over the 1-year follow-up partially mediated the interventions of Mediterranean diet supplemented with extra virgin olive oil or mixed nuts.

The researchers suggested future studies broaden the demographic population to include different backgrounds and eating habits as well as further evaluate the biological mechanisms involved in dyslipidemia.

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Early detection of lipidome characteristics could help identify the early onset of T2D and lead to earlier prevention or intervention, concluded the researchers.

Several authors received personal fees from pharmaceutical and beverage companies. For a full list of disclosures, see the reference.

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Razquin C, Toledo E, Clish CB, et al. Plasma lipidomic profiling and risk of type 2 diabetes in the PREDIMED Trial [published October 16, 2018]. Diabetes Care. doi:10.2337/dc18-0840