Blood Lipid Changes at Age 8 in Kids Genetically Prone to Diabetes

Becky McCall

September 18, 2019

BARCELONA — Metabolic signs of type 2 diabetes are detectable in the blood of some children as young as 8 years old, according to the results of a large epidemiological study presented here at the European Association for the Study of Diabetes (EASD) 2019 Annual Meeting.

"It's remarkable that we can see signs of adult diabetes in the blood from such a young age — this is about 50 years before it is commonly diagnosed," said lead researcher Joshua Bell, PhD, MRC Integrative Epidemiology Unit, University of Bristol, UK.

Bell and colleagues used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) study to look at the early features of type 2 diabetes in children aged 8 and older.

The researches assessed genetic liability in the kids using variants known to be associated with adult diabetes and calculated a genetic risk score, which was cross-referenced with metabolic markers in the blood measured at four time points as the children grew up, until the age of 25. The full article is also available online.

"This was a way of trying to piece together what the disease looks like as it's developing," he told Medscape Medical News.

Specifically, one of the earliest features to change in the blood was metabolism of high-density lipoprotein cholesterol (HDL-C) or "good" cholesterol. Low levels of this marker appeared to be correlated with higher genetic likelihood of developing type 2 diabetes in adulthood, Bell explained

These changes occurred before any alterations in low-density lipoprotein cholesterol (LDL-C) or "bad" cholesterol.

Session moderator Naveed Sattar, MD, from the Institute of Cardiovascular & Medical Sciences at the University of Glasgow, UK, welcomed the work but pointed out that it is unlikely this information would be used clinically, at least at the present time.

"It does add a little bit of new information on what the pathways to diabetes may be — so only of research interest currently — not for the clinic for many years, if ever," he observed.

"We already have good risk scores based on questions and simple measurements of weight or waist...which help signal those at high risk [of diabetes] who should consider getting tested for it," he added.

What Are the Earliest Features of Type 2 Diabetes? How Do They Unfold?

Bell explained that type 2 diabetes takes many years to develop and, based on adult data, it has been established that disease-related changes can occur in the decade or two leading up to diagnosis.

"What we don't know is what the very early beginnings of disease look like," he explained.

Using the ALSPAC data (also known as the cohort of the 90s study), Bell and colleagues genotyped 4765 children for 162 genetic variants of adult type 2 diabetes and also examined lipid measures — including triglycerides as well as a number of amino acids and fatty acids — in blood samples taken at ages 8, 15, 18, and 25 years.

"We wanted to know the effect of that genetic susceptibility on blood markers. How early in life do we see the beginning of disease activity? And how does it unfold?" he told Medscape Medical News.

He acknowledged the findings "are more preclinical than clinical," but stressed they provide some early insight into "what features might be targeted to prevent progression to clinical disease."

Elizabeth Robertson, PhD, director of research at Diabetes UK, said the findings may indeed be of use in years to come.

"In the future, insights like these could mean we're able to spot who is at a higher risk and — most importantly – find ways to intervene to reduce this risk much earlier in a person's life than we're able to today and...potentially prevent more cases of type 2 diabetes from developing at all," she commented.

"Although we can't do anything about our genetic risk, there are things you can do to help lower your risk of developing the condition that include maintaining a healthy weight, eating well, and moving more," she noted.

EASD 2019 Annual Meeting. Presented September 19, 2019. Abstract 81.

Bell has reported no relevant financial relationships.

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