Type 2 diabetes is a growing global epidemic, with 6% of the world population suffering from the disease. However, the risk of developing type 2 diabetes can be greatly reduced by weight control, eating well and exercising before the actual manifestation of the disease. Early detection of type 2 diabetes risk before symptoms could help minimize health complications related to diabetes.
In the study published in Nature Communications entitled " Elevated circulating follistatin associates with an increased risk of type 2 diabetes", the researchers found that higher levels of the protein follistatin circulating in the blood predict type 2 diabetes up to nineteen years before the onset of the disease, regardless of other known risk factors, such as age, body mass index (BMI), fasting blood glucose levels, diet or physical activity. Dr. Yang De Marinis, Associate Professor at Lund University is the lead author of the study.
This discovery is based on studies that followed 5,318 people over the course of 4 to 19 years in two different locations in Sweden and Finland. The study then revealed what happens to the body when follistatin in the blood circulation becomes too high. Follistatin is a protein that is mainly secreted from the liver and involved in the regulation of metabolism. Using clinical data from the German Tübingen Diabetes Family Study and cell biology investigation, the researchers found that follistatin promotes fat breakdown from the adipose tissue, resulting in increased lipid accumulation in the liver. This in turn increases the risk of nonalcoholic fatty liver disease and type 2 diabetes.
To find out what regulates blood follistatin levels, the researchers performed genome-wide association study (GWAS) on 5,124 people from Sweden, the UK and Italy, and revealed that follistatin levels are genetically regulated by glucokinase regulatory protein (GCKR), which impact on several metabolic traits.
This study shows that follistatin has the potential to become an important biomarker to predict future type 2 diabetes, it also brings us one step closer to the understanding of the mechanisms behind the disease.