Water T2 as an early, global and practical biomarker for metabolic syndrome: an observational cross-sectional study
Robinson, Michelle D.; Mishra, Ina; Deodhar, Sneha; Patel, Vipulkumar; Gordon, Katrina V.; Vintimilla, Raul; Brown, Kim; Johnson, Leigh; O’Bryant, Sid; Cistola, David P.
Background: Metabolic syndrome (MetS) is a highly prevalent condition that identifies individuals at risk for type 2 diabetes mellitus and atherosclerotic cardiovascular disease. Prevention of these diseases relies on early detection and intervention in order to preserve pancreatic β-cells and arterial wall integrity. Yet, the clinical criteria for MetS are insensitive to the early-stage insulin resistance, inflammation, cholesterol and clotting factor abnormalities that char- acterize the progression toward type 2 diabetes and atherosclerosis. Here we report the discovery and initial charac- terization of an atypical new biomarker that detects these early conditions with just one measurement. Methods: Water T2, measured in a few minutes using benchtop nuclear magnetic resonance relaxometry, is exqui- sitely sensitive to metabolic shifts in the blood proteome. In an observational cross-sectional study of 72 non-diabetic human subjects, the association of plasma and serum water T2 values with over 130 blood biomarkers was analyzed using bivariate, multivariate and logistic regression. Results: Plasma and serum water T2 exhibited strong bivariate correlations with markers of insulin, lipids, inflamma- tion, coagulation and electrolyte balance. After correcting for confounders, low water T2 values were independently and additively associated with fasting hyperinsulinemia, dyslipidemia and subclinical inflammation. Plasma water T2 exhibited 100% sensitivity and 87% specificity for detecting early insulin resistance in normoglycemic subjects, as defined by the McAuley Index. Sixteen normoglycemic subjects with early metabolic abnormalities (22% of the study population) were identified by low water T2 values. Thirteen of the 16 did not meet the harmonized clinical criteria for metabolic syndrome and would have been missed by conventional screening for diabetes risk. Low water T2 values were associated with increases in the mean concentrations of 6 of the 16 most abundant acute phase proteins and lipoproteins in plasma. Conclusions: Water T2 detects a constellation of early abnormalities associated with metabolic syndrome, provid- ing a global view of an individual’s metabolic health. It circumvents the pitfalls associated with fasting glucose and hemoglobin A1c and the limitations of the current clinical criteria for metabolic syndrome. Water T2 shows promise as an early, global and practical screening tool for the identification of individuals at risk for diabetes and atherosclerosis.
Robinson, Michelle D., & Mishra, Ina, & Deodhar, Sneha, & Patel, Vipulkumar, & Gordon, Katrina V., & Vintimilla, Raul, & Brown, Kim, & Johnson, Leigh, & O’Bryant, Sid, & Cistola, David P.. (December 2017). Water T2 as an early, global and practical biomarker for metabolic syndrome: an observational cross-sectional study. Journal of Translational Medicine, (15:1), p.. Retrieved from http://hdl.handle.net/10342/8427
Robinson, Michelle D., and Mishra, Ina, and Deodhar, Sneha, and Patel, Vipulkumar, and Gordon, Katrina V., and Vintimilla, Raul, and Brown, Kim, and Johnson, Leigh, and O’Bryant, Sid, and Cistola, David P.. "Water T2 as an early, global and practical biomarker for metabolic syndrome: an observational cross-sectional study". Journal of Translational Medicine. 15:1. (.), December 2017. August 14, 2020. http://hdl.handle.net/10342/8427.
Robinson, Michelle D. and Mishra, Ina and Deodhar, Sneha and Patel, Vipulkumar and Gordon, Katrina V. and Vintimilla, Raul and Brown, Kim and Johnson, Leigh and O’Bryant, Sid and Cistola, David P., "Water T2 as an early, global and practical biomarker for metabolic syndrome: an observational cross-sectional study," Journal of Translational Medicine 15, no. 1 (December 2017), http://hdl.handle.net/10342/8427 (accessed August 14, 2020).
Robinson, Michelle D., Mishra, Ina, Deodhar, Sneha, Patel, Vipulkumar, Gordon, Katrina V., Vintimilla, Raul, Brown, Kim, Johnson, Leigh, O’Bryant, Sid, Cistola, David P.. Water T2 as an early, global and practical biomarker for metabolic syndrome: an observational cross-sectional study. Journal of Translational Medicine. December 2017; 15(1) . http://hdl.handle.net/10342/8427. Accessed August 14, 2020.