TY - JOUR T1 - Plasma N-glycome shows continuous deterioration as the diagnosis of insulin resistance approaches JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2021-002263 VL - 9 IS - 1 SP - e002263 AU - Ana Cvetko AU - Massimo Mangino AU - Marko Tijardović AU - Domagoj Kifer AU - Mario Falchi AU - Toma Keser AU - Markus Perola AU - Tim D Spector AU - Gordan Lauc AU - Cristina Menni AU - Olga Gornik Y1 - 2021/09/01 UR - http://drc.bmj.com/content/9/1/e002263.abstract N2 - Introduction Prediction of type 2 diabetes mellitus (T2DM) and its preceding factors, such as insulin resistance (IR), is of great importance as it may allow delay or prevention of onset of the disease. Plasma protein N-glycome has emerged as a promising predictive biomarker. In a prospective longitudinal study, we included patients with a first diagnosis of impaired glucose metabolism (IR or T2DM) to investigate the N-glycosylation’s predictive value years before diabetes development.Research design and methods Plasma protein N-glycome was profiled by hydrophilic interaction ultra-performance liquid chromatography in 534 TwinsUK participants free from disease at baseline. This included 89 participants with incident diagnosis of IR or T2DM during the follow-up period (7.14±3.04 years) whose last sample prior to diagnosis was compared using general linear regression with 445 age-matched unrelated controls. Findings were replicated in an independent cohort. Changes in N-glycome have also been presented in connection with time to diagnosis.Results Eight groups of plasma N-glycans were different between incident IR or T2DM cases and controls (p<0.05) after adjusting for multiple testing using Benjamini-Hochberg correction. These differences were noticeable up to 10 years prior to diagnosis and are changing continuously as becoming more expressed toward the diagnosis. The prediction model was built using significant glycan traits, displaying a discriminative performance with an area under the receiver operating characteristic curve of 0.77.Conclusions In addition to previous studies, we showed the diagnostic potential of plasma N-glycome in the prediction of both IR and T2DM development years before the clinical manifestation and indicated the continuous deterioration of N-glycome toward the diagnosis.Data are available upon reasonable request. The datasets used and analysed during the current study are available from the corresponding author on reasonable request. ER -