Abstract

Background: The increasing prevalence of diabetes mellitus, a major cause of morbidity and mortality worldwide, is a critical public health concern. Though a number of studies have evaluated the associations of metabolites with prediabetes and diabetes, further exploration in this relatively new field may identify novel biomarkers for predicting, detecting, and managing hyperglycemia and diabetes. Objective: We conducted a metabolome-wide association study among 805 white and 426 African-American participants of the Bogalusa Heart Study (BHS) to identify metabolites associated with markers of glycemia and diabetes. Methods: After rigorous quality control, 1,202 metabolites quantified by untargeted, ultra-high performance liquid chromatography tandem-mass spectroscopy were tested for association with fasting glucose, hemoglobin A1c and diabetes. Multiple regression analyses were run in race-stratified and combined samples, adjusting for age, sex, education, blood pressure, body mass index, HDL-cholesterol, smoking, eGFR, fasting glucose (for HbA1c and diabetes), and race (in combined analyses). For fasting glucose and HbA1c, those taking diabetes medications were excluded. Metabolites were considered significant if they were significant (P<4.15х10 -5 ; Bonferroni corrected for 1,202 metabolites) in one race group and the entire cohort, with a similar trend observed in the other race group. Results: After Bonferroni corrections, among 72 metabolites significantly associated with at least one glycemic outcome, 27 were novel and in known pathways: 5 from amino acid, 1 from carbohydrate, 18 from lipid, 1 from xenobiotics, and 2 from nucleotide pathways. Metabolites consistently associated with diabetes are shown in the Table . Conclusions: These results identified novel metabolites associated with glycemic outcomes, providing additional evidence on the importance of serum metabolites in hyperglycemia and diabetes.

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