Abstract
Insulin is crucial for regulating carbohydrate and lipid metabolism. In insulin resistance,
alterations in serum acylcarnitine (AcylCarn) profiles between fasted and fed states may occur
early, reflecting metabolic dysregulation. However, few have examined AcylCarn changes in
diagnosing fatty acid metabolism disturbances in disorders like prediabetes and diabetes
mellitus (DM). Given the limitations of current diagnostic criteria for prediabetes and DM, this
study aimed to compare serum AcylCarn profiles during a mixed meal test (MMT) in healthy
individuals, prediabetes patients, and those with type 2 DM.
The study involved 45 participants: 13 healthy controls, 17 with prediabetes, and 15 with
type 2 DM. Ages ranged from 28 to 76 years (median 48). The MMT meal contained yogurt
and a muesli bar, with plasma samples collected preprandially and at 30, 60, and 120 minutes
postprandially to assess serum glucose, c-peptide, and AcylCarn profiles (short-chain AcylCarn
(SCAC) C2–C4, medium-chain AcylCarn (MCAC) C5–C10, and long-chain AcylCarn
(LCAC) C12–C18). Statistical analysis was performed using the Kruskal–Wallis test.
The control group had significantly lower baseline glucose (4.7mmol/L, 95%CI[4.5;5.0])
compared to prediabetes (5.4mmol/L, 95%CI[5.0;5.7],p=0.044) and DM groups (6.2mmol/L,
95%CI[5.3;7.2],p=0.002). The control group also showed lower glucose elevations across all
time points. AcylCarn concentrations changed significantly during the MMT. At 30 minutes,
SCAC concentrations decreased more in the control group than in the prediabetes group
(p=0.008), but not in the DM group. Similarly, MCAC decreased more in the control group
compared to both prediabetes (p=0.0004) and DM groups (p=0.017). LCAC also decreased
more in the control group than the prediabetes group at 30 minutes, but not in the DM group.
At 60 minutes, SCAC decreased by 33.6% from baseline in the control group (IQR 28.6–37.2),
significantly lower than in the prediabetes (5.1%, IQR -1.6–20.3,p=0.004) and DM groups
(15.9%, IQR 0–23.1,p=0.045). MCAC decreased by 42.1% (IQR 38.5–54.7) in the control
group, more than both prediabetes (27.8%, IQR 4.1–34.9,p=0.002) and DM groups (13.9%,
IQR 5.4–41.9,p=0.008). LCAC decreased by 39.5% (IQR 54.4–78.3) in the control group, more
than the prediabetes group (19.6%, IQR 6.4–27.1,p=0.011), but not the DM group. At 120
minutes, only SCAC decreased significantly more in the control group than in prediabetes
(p=0.043).
These findings suggest that changes in serum AcylCarn concentrations during the MMT
could be a useful tool for diagnosing prediabetes and possibly DM. Further studies are needed
to establish specific diagnostic cut-off values.
alterations in serum acylcarnitine (AcylCarn) profiles between fasted and fed states may occur
early, reflecting metabolic dysregulation. However, few have examined AcylCarn changes in
diagnosing fatty acid metabolism disturbances in disorders like prediabetes and diabetes
mellitus (DM). Given the limitations of current diagnostic criteria for prediabetes and DM, this
study aimed to compare serum AcylCarn profiles during a mixed meal test (MMT) in healthy
individuals, prediabetes patients, and those with type 2 DM.
The study involved 45 participants: 13 healthy controls, 17 with prediabetes, and 15 with
type 2 DM. Ages ranged from 28 to 76 years (median 48). The MMT meal contained yogurt
and a muesli bar, with plasma samples collected preprandially and at 30, 60, and 120 minutes
postprandially to assess serum glucose, c-peptide, and AcylCarn profiles (short-chain AcylCarn
(SCAC) C2–C4, medium-chain AcylCarn (MCAC) C5–C10, and long-chain AcylCarn
(LCAC) C12–C18). Statistical analysis was performed using the Kruskal–Wallis test.
The control group had significantly lower baseline glucose (4.7mmol/L, 95%CI[4.5;5.0])
compared to prediabetes (5.4mmol/L, 95%CI[5.0;5.7],p=0.044) and DM groups (6.2mmol/L,
95%CI[5.3;7.2],p=0.002). The control group also showed lower glucose elevations across all
time points. AcylCarn concentrations changed significantly during the MMT. At 30 minutes,
SCAC concentrations decreased more in the control group than in the prediabetes group
(p=0.008), but not in the DM group. Similarly, MCAC decreased more in the control group
compared to both prediabetes (p=0.0004) and DM groups (p=0.017). LCAC also decreased
more in the control group than the prediabetes group at 30 minutes, but not in the DM group.
At 60 minutes, SCAC decreased by 33.6% from baseline in the control group (IQR 28.6–37.2),
significantly lower than in the prediabetes (5.1%, IQR -1.6–20.3,p=0.004) and DM groups
(15.9%, IQR 0–23.1,p=0.045). MCAC decreased by 42.1% (IQR 38.5–54.7) in the control
group, more than both prediabetes (27.8%, IQR 4.1–34.9,p=0.002) and DM groups (13.9%,
IQR 5.4–41.9,p=0.008). LCAC decreased by 39.5% (IQR 54.4–78.3) in the control group, more
than the prediabetes group (19.6%, IQR 6.4–27.1,p=0.011), but not the DM group. At 120
minutes, only SCAC decreased significantly more in the control group than in prediabetes
(p=0.043).
These findings suggest that changes in serum AcylCarn concentrations during the MMT
could be a useful tool for diagnosing prediabetes and possibly DM. Further studies are needed
to establish specific diagnostic cut-off values.
| Original language | English |
|---|---|
| Pages | 100 |
| Publication status | Published - 2025 |
| Event | FEBS3+ Baltics: Biochemistry at the Fore Line - Vilnius University's Life Sciences Center, Vilnius, Lithuania Duration: 23 Apr 2025 → 25 Apr 2025 https://www.febs3vilnius.lt/ |
Conference
| Conference | FEBS3+ Baltics: Biochemistry at the Fore Line |
|---|---|
| Country/Territory | Lithuania |
| City | Vilnius |
| Period | 23/04/25 → 25/04/25 |
| Internet address |
Field of Science*
- 3.2 Clinical medicine
- 3.3 Health sciences
- 3.1 Basic medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)
