Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/69804
Title: Plasma acylcarnitines and risk of type 2 diabetes in a mediterranean population at high cardiovascular risk
Authors: Guasch-Ferré, Marta
Ruiz-Canela, Miguel
Li, Jun
Zheng, Yan
Bulló, Mònica
Wang, Dong D.
Toledo, Estefanía
Clish, Clary
Corella, Dolores
Estruch, Ramon
Ros, Emilio
Fitó, Montserrat
Arós, Fernando
Fiol, Miquel
Lapetra, José
Serra Majem, Luis 
Liang, Liming
Papandreou, Christopher
Dennis, Courtney
Martínez-González, Miguel A.
Hu, Frank B.
Salas-Salvadó, Jordi
UNESCO Clasification: 32 Ciencias médicas
Issue Date: 2019
Journal: Journal of Clinical Endocrinology and Metabolism 
Abstract: Context: The potential associations between acylcarnitine profiles and incidence of type 2 diabetes (T2D) and whether acylcarnitines can be used to improve diabetes prediction remain unclear. Objective: To evaluate the associations between baseline and 1-year changes in acylcarnitines and their diabetes predictive ability beyond traditional risk factors. Design, Setting, and Participants: We designed a case-cohort study within the PREDIMED Study including all incident cases of T2D (n = 251) and 694 randomly selected participants at baseline (follow-up, 3.8 years). Plasma acylcarnitines were measured using a targeted approach by liquid chromatography-tandem mass spectrometry. We tested the associations between baseline and 1-year changes in individual acylcarnitines and T2D risk using weighted Cox regression models. We used elastic net regressions to select acylcarnitines for T2D prediction and compute a weighted score using a cross-validation approach. Results: An acylcarnitine profile, especially including short- and long-chain acylcarnitines, was significantly associated with a higher risk of T2D independent of traditional risk factors. The relative risks of T2D per SD increment of the predictive model scores were 4.03 (95% CI, 3.00 to 5.42; P < 0.001) for the conventional model and 4.85 (95% CI, 3.65 to 6.45; P <0.001) for the model including acylcarnitines, with a hazard ratio of 1.33 (95% CI, 1.08 to 1.63; P < 0.001) attributed to the acylcarnitines. Including the acylcarnitines into the model did not significantly improve the area under the receiver operator characteristic curve (0.86 to 0.88, P = 0.61). A 1-year increase in C4OHcarnitine was associated with higher risk of T2D [per SD increment, 1.44 (1.03 to 2.01)]. Conclusions: An acylcarnitine profile, mainly including short- and long-chain acylcarnitines, was significantly associated with higher T2D risk in participants at high cardiovascular risk. The inclusion of acylcarnitines into the model did not significantly improve the T2D prediction C-statistics beyond traditional risk factors, including fasting glucose.
URI: http://hdl.handle.net/10553/69804
ISSN: 0021-972X
DOI: 10.1210/jc.2018-01000
Source: Journal of Clinical Endocrinology and Metabolism [ISSN 0021-972X], v. 104 (5), p. 1508-1519
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