Abstract

Introduction: The global prevalence of type 2 diabetes (T2D) is increasing rapidly, especially in low- and middle-income countries and has a high number of associated comorbidities. Plasmatic concentrations of branched chain amino acids (BCAA) and retinol-binding protein 4 (RBP4) have been shown to be elevated in T2D subjects in cross-sectional studies. However, the effect of lifestyle community-based interventions on BCAA and RBP4 concentrations has not yet been analyzed. Material and methods: The Feel4Diabetes study is a school and community-based intervention that identified 360 European families with a high risk of developing T2D according to the FINDRISC questionnaire. Families were randomized in control and intervention groups were followed-up from 2016 to 2018. In the Spanish families, the concentration of BCAA and RBP4 was determined in 266 subjects (115 control and 151 intervention group) that attended the three time-point assessments by colorimetric and ELISA reaction, respectively. Results: Baseline BCAA levels showed positive correlations with the FINDRISC score and glucose impairment (baseline glucose, insulin, and glycated hemoglobin), body mass index, and body weight. The participants receiving the community-based intervention showed a significant decrease in glycated hemoglobin and BCAA levels compared to the control group (p = 0.011 and p < 0.001, respectively). However, baseline RBP4 did not show significant correlations with anthropometric and glycemic parameters, and no significant change was observed in anthropometric parameters and RBP4 concentrations throughout the follow-up. Conclusion: A community-based intervention on lifestyle led to a significant reduction in BCAA levels regardless of weight loss. These findings suggest that this interventional approach could be promising in T2D prevention.

Highlights

  • The global prevalence of type 2 diabetes (T2D) is increasing rapidly, especially in low- and middle-income countries and has a high number of associated comorbidities

  • Most of the studies exploring the association between branched chain amino acids (BCAA) and retinol-binding protein 4 (RBP4) with glucose metabolism impairment are observational and they have been carried out in subjects with prediabetes or T2D

  • The aim of this study is to explore the circulating levels of BCAA and RBP4 in adult subjects with high risk of developing T2D, based on a validated questionnaire (Finnish Diabetes Risk Score, FINDRISC), to find if they are related to glucose parameters and if a community-based lifestyle intervention has a significant impact on their concentrations

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Summary

Introduction

The global prevalence of type 2 diabetes (T2D) is increasing rapidly, especially in low- and middle-income countries and has a high number of associated comorbidities. Retinol-binding protein 4 (RBP4) is a recently recognized adipokine, and several epidemiological studies have demonstrated that elevated serum RBP4 concentrations play a critical role in the development of insulin resistance and T2D [14,15]. While subjects with high risk of developing T2D have elevated levels of BCAA and RBP4; whether they are related to glucose homeostasis and lifestyle intervention which could impact their concentrations has not been previously explored and could be useful to find early markers of disease onset. The aim of this study is to explore the circulating levels of BCAA and RBP4 in adult subjects with high risk of developing T2D, based on a validated questionnaire (Finnish Diabetes Risk Score, FINDRISC), to find if they are related to glucose parameters and if a community-based lifestyle intervention has a significant impact on their concentrations

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