A new study is proposing blood levels of a specific protein may serve as a useful predictor of type 2 diabetes developing up to two decades before any symptoms appear. The findings indicate a diagnostic blood test could be deployed to offer people a way to assess their future risk of developing the disease.

Follistatin is a protein initially discovered in the late 1980s and studied for its role as a reproductive hormone. It is secreted by almost all tissues in the human body and subsequently has been found to play a significant role in many metabolic processes.

The liver is one of the primary secretors of follistatin. Over the last decade researchers have found patients with type 2 diabetes often display elevated blood levels of this protein, so this new research set out to clarify whether these elevated blood follistatin levels precede the development of type 2 diabetes.

Looking at data from the Malmö Diet and Cancer Cardiovascular Cohort, an ongoing long-term health study, the researchers studied follistatin levels in nearly 5,000 subjects. Independent of other risk factors the researchers found high circulating follistatin levels were associated with the development of type 2 diabetes long before the disease developed.

“We found that higher levels of the protein follistatin circulating in the blood predict type 2 diabetes up to 19 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,” says lead author on the new study, Yang De Marinis.

Prior animal studies have found follistatin can exacerbate insulin resistance and promote the accumulation of fatty tissue in the liver. This offers a plausible mechanism by which heightened follistatin levels could increase a person’s risk of developing type 2 diabetes.

The new study also conducted a genomic analysis to find out whether there was a genetic association with high follistatin levels. A specific variant in the GCKR gene was found to particularly correlate with high follistatin levels.

Significantly, this variant has been previously linked to a number of metabolic traits, including heightened type 2 diabetes risk. The new research hypothesizes this follistatin discovery as the mechanism that connects this gene variant to diabetes.

“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,” notes De Marinis.

A commercial company called Lundoch Diagnostics has been founded by De Marinis and others, and is working on an AI-based diagnostic tool that incorporates blood follistatin levels into an overall risk score measuring a person’s future likelihood of developing type 2 diabetes.

The goal, according to De Marinis, is to offer a simple diagnostic blood test that can help people understand their personal risk for developing type 2 diabetes, allowing for preventative measures to be deployed early on to stop the disease before it progresses.

“This discovery holds the opportunity of instituting measures to prevent type 2 diabetes from becoming established,” adds De Marinis. “Our research will continue towards this goal.”

The new study was published in the journal Nature Communications.

Source: Lund University