Diabetes breakthrough: Blood biomarker predicts disease onset 19 years before diagnosis

LUND, Sweden — A single protein in the blood could help doctors predict if someone will develop type 2 diabetes nearly two decades before the onset of the disease. Researchers from Lund University discovered that levels of a protein called follistatin in the blood can reveal a person’s risk for diabetes up to 19 years before signs of blood sugar dysfunction even appear.

Study author Dr. Yang De Marinis notes that high follistatin levels appear to be predictive of type 2 diabetes onset regardless of the patient’s age, body mass index, blood glucose levels, diet, and level of physical activity. Follistatin is a protein involved in regulating a person’s metabolism. The liver is mainly responsible for secreting this substance.

The new study finds that follistatin promotes fat breakdown from the adipose tissue (body fat). However, this leads to increased fat accumulation in the liver. The result of this is a higher risk of nonalcoholic fatty liver disease and type 2 diabetes. Just like the triggers for diabetes, like obesity, human behavior can play a role in having higher follistatin levels.

“Previous studies showed that blood follistatin levels may fluctuate in response to food intake and physical activities, as well as conditions such as pregnancy. Once follistatin levels persist to stay too high, this may lead to fat release from the adipose tissue and consequently increased fat storage in the liver and risk for type 2 diabetes and non-alcoholic fatty liver disease as shown in our study,” Dr. Yang De Marinis tells StudyFinds in a statement.

Healthy eating may keep follistatin in check

Type 2 diabetes is a growing health problem around the world, with studies estimating that nearly half a billion people may have the condition. Although weight loss, healthy diet changes, and exercising can help reduce symptoms and even prevent diabetes onset, early detection of disease risk factors is also key to a healthy life.

Researchers followed over 5,300 people from Sweden and Finland for between four and 19 years. In a genome-wide association study, the team discovered that the glucokinase regulatory protein (GCKR) genetically regulates follistatin levels, impacting several metabolic traits.

“This study shows that follistatin has the potential to become an important biomarker to predict future type 2 diabetes, and it also brings us one step closer to the understanding of the mechanisms behind the disease,” De Marinis notes in a university release.

The next step in turning follistatin into a diabetes warning marker involves an artificial intelligence diagnostic tool, which De Marinis’ biotech startup Lundoch is developing. The tool aims to create a simple blood test which provides users with a personal risk score for diabetes development in the future.

As for what people can do to manage and lower their follistatin levels right now, Dr. De Marinis says keep taking the steps which lower the overall chances of diabetes in terms of dieting and physical activity.

“Balanced meals, eat healthy and regular exercise are important to decrease the risk of developing type 2 diabetes,” the study author tells StudyFinds.

The study is published in the journal Nature Communications.