Serum Carnitine Metabolites and Incident Type 2 Diabetes Mellitus in Patients with Suspected Stable Angina Pectoris.

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Serum Carnitine Metabolites and Incident Type 2 Diabetes Mellitus in Patients with Suspected Stable Angina Pectoris.

J Clin Endocrinol Metab. 2018 Jan 09;:

Authors: Strand E, Rebnord EW, Flygel MR, Lysne V, Svingen GFT, Tell GS, Løland KH, Berge RK, Svardal A, Nygård O, Pedersen ER

Abstract
Context: Carnitine and its metabolites are centrally involved in fatty acid metabolism. While elevated circulating concentrations have been observed in obesity and insulin resistance, prospective studies examining whether these metabolites are associated with incident type 2 diabetes mellitus (T2D) are sparse.
Objective: We performed a comprehensive evaluation of metabolites along the carnitine pathway in relation to incident T2D.
Design: A total of 2519 patients (73.1% men) with coronary artery disease, but without T2D, were followed for median 7.7 years until the end of 2009 during which 173 (6.9%) new cases of T2D were identified. Serum levels of free carnitine, its precursors trimethyllysine (TML) and γ-butyrobetaine, and the esters acetyl-, propionyl-, (iso)valeryl-, octanoyl-, and palmitoylcarnitine were measured by liquid chromatography/tandem mass spectrometry. Risk associations were explored by logistic regression and are reported per (log-transformed) standard deviation increment.
Results: Median age at inclusion was 62 years and median body mass index (BMI) 26.0 kg/m2. In models adjusted for age, sex, fasting status, body mass index, estimated glomerular filtration rate, glycated hemoglobin A1c, triglycerides, HDL-cholesterol, and study center, serum levels of TML and palmitoylcarnitine associated positively [ORs (95% CIs) 1.22 (1.04-1.43) and 1.24 (1.04-1.49), respectively], while γ-butyrobetaine associated negatively [0.81 (0.66-0.98)] with T2D risk.
Conclusions: Serum levels of TML, γ-butyrobetaine, and the long-chained palmitoylcarnitine predict long-term risk of T2D independently of traditional risk factors, possibly reflecting dysfunctional fatty acid metabolism in subjects susceptible for T2D development.

PMID: 29325058 [PubMed - as supplied by publisher]

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