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New Test Could Reveal Diabetes Risk Years Before Disease Onset

Researchers identify SFRP4 protein as strong risk marker (Nov. 7)

By the time a patient is diagnosed with type 2 diabetes, the disease has usually progressed over several years, and damage — such as to blood vessels and the eyes — has already taken place. A test that indicates who is at risk for the disease at an early stage would be valuable, as it would allow clinicians to begin preventive treatment. Researchers at Lund University in Sweden have identified a promising candidate for such a test.

“We have shown that individuals who have above-average levels of a protein called SFRP4 in the blood are five times more likely to develop diabetes in the next few years than are those with below-average levels,” said lead researcher Dr. Anders Rosengren.

This is the first time that a link has been established between SFRP4 — which plays a role in inflammatory processes — and the risk of type 2 diabetes. The new study compared donated insulin-producing beta cells from diabetic and nondiabetic individuals. Cells from the diabetic subjects had significantly higher levels of SFRP4.

It is also the first time that a link between inflammation in beta cells and diabetes has been proven.

“The theory has been that low-grade chronic inflammation weakens the beta cells so that they are no longer able to secrete sufficient insulin. There are no doubt multiple reasons for the weakness, but the SFRP4 protein is one of them,” said primary author Dr. Taman Mahdi.

The level of SFRP4 in the blood of nondiabetics was measured three times at intervals of 3 years. Thirty-seven percent of those with higher-than-average levels of the protein developed diabetes during the study period. Among those with lower-than-average levels of SFRP4, only 9% developed diabetes.

“This makes SFRP4 a strong risk marker that is present several years before diagnosis. We have also identified the mechanism for how SFRP4 impairs the secretion of insulin. The marker therefore reflects not only an increased risk, but also an ongoing disease process,” Rosengren said.

The marker is independent of other known risk factors for type 2 diabetes, such as obesity and age.

“If we can point to an increased risk of diabetes in a middle-aged individual of normal weight using a simple blood test up to 10 years before the disease develops, this could provide strong motivation for them to improve their lifestyle to reduce the risk,” Rosengren remarked.

“In the long term, our findings could also lead to new methods of treating type 2 diabetes by developing ways of blocking the protein SFRP4 in insulin-producing beta cells and reducing inflammation, thereby protecting the cells,” he added.

The new study was published in Cell Metabolism.

Source: Lund University; November 7, 2012.

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