Running title: amino acids and prediabetes risk in blacks and whites

Abstract

Circulating branched-chain amino acids (BCAAs, isoleucine, leucine, valine) and aromatic amino acids (AAAs, tyrosine and phenylalanine) predicted type 2 diabetes mellitus (T2DM) risk in a Caucasian population. Here, we assessed amino acid levels in relation to incident prediabetes among initially normoglycemic African Americans (AA) and European Americans (EA). Using a nested case-control design, we studied 70 adults (35 AA, 35 EA) who developed prediabetes (progressors) and 70 matched participants who maintained normoglycemia (nonprogressors) during 5.5 years of follow-up in the Pathobiology of Prediabetes in a Biracial Cohort study. Assessments included plasma amino acid levels, insulin sensitivity, and beta-cell function. The total level of all 18 amino acid assayed was significantly associated with lean mass (r=0.36, P<0.0001), waist circumference (r=0.27, P=0.001), fasting plasma glucose (r=0.24, P=0.005), HOMA-IR (r=0.22, P=0.01) and HDL cholesterol (r= −0.18, P=0.03). Individual amino acid levels were significantly associated with insulin sensitivity and insulin secretion. Compared with nonprogressors, progressors had higher baseline levels of asparagine and aspartic acid (P=<0.0001), glutamine/glutamic acid (P=0.005) and phenylalanine (P=0.02), and lower histidine (P=0.02) levels. In fully-adjusted logistic regression models, aspartic acid/asparagine (OR 2.72 [95% CI 1.91–3.87) and histidine (OR 0.90 [95% CI 0.85–0.96) were the only amino acids that significantly predicted incident prediabetes. Baseline plasma aspartic acid and asparagine levels predicted progression to prediabetes, whereas histidine levels were protective of prediabetes risk. Thus, the amino acid signature associated with prediabetes in a diverse population may be distinct from that previously linked to T2DM in Caucasians.