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Abstract
Studies examining associations between purine metabolites and type 2 diabetes (T2D) are limited. We prospectively examined associations between plasma levels of purine metabolites with T2D risk and the modifying effects of transcription factor-7-like-2 (TCF7L2) rs7903146 polymorphism on these associations. This is a case-cohort design study within the PREDIMED study, with 251 incident T2D cases and a random sample of 694 participants (641 non-cases and 53 overlapping cases) without T2D at baseline (median follow-up: 3.8 years). Metabolites were semi-quantitatively profiled with LC-MS/MS. Cox regression analysis revealed that high plasma allantoin levels, including allantoin-to-uric acid ratio and high xanthine-to-hypoxanthine ratio were inversely and positively associated with T2D risk, respectively, independently of classical risk factors. Elevated plasma xanthine and inosine levels were associated with a higher T2D risk in homozygous carriers of the TCF7L2-rs7903146 T-allele. The potential mechanisms linking the aforementioned purine metabolites and T2D risk must be also further investigated.
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1 Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Human Nutrition Unit, Faculty of Medicine and Health Sciences, Reus, Spain (GRID:grid.410367.7) (ISNI:0000 0001 2284 9230); Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427)
2 Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
3 Harvard T.H. Chan School of Public Health, Departments of Epidemiology and Statistics, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
4 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain (GRID:grid.5924.a) (ISNI:0000000419370271)
5 Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, Human Nutrition Unit, Faculty of Medicine and Health Sciences, Reus, Spain (GRID:grid.410367.7) (ISNI:0000 0001 2284 9230); Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
6 Broad Institute of MIT and Harvard University, Cambridge, USA (GRID:grid.66859.34)
7 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); University of Valencia, Department of Preventive Medicine, Valencia, Spain (GRID:grid.5338.d) (ISNI:0000 0001 2173 938X)
8 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Hospital Clinic, University of Barcelona, Department of Internal Medicine, Department of Endocrinology and Nutrition Institut d’Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Barcelona, Spain (GRID:grid.410458.c) (ISNI:0000 0000 9635 9413)
9 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); University of Barcelona, Lipid Clinic, Department of Endocrinology and Nutrition Institut d’Investigacions Biomediques August Pi Sunyer (IDI- BAPS), Hospital Clinic, Barcelona, Spain (GRID:grid.5841.8) (ISNI:0000 0004 1937 0247)
10 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Institut de Recerca Hospital del Mar, Cardiovascular and Nutrition Research Group, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811)
11 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); University Hospital of Alava, Department of Cardiology, Vitoria, Spain (GRID:grid.413448.e)
12 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); University of Las Palmas de Gran Canaria, Department of Clinical Sciences, Las Palmas, Spain (GRID:grid.4521.2) (ISNI:0000 0004 1769 9380)
13 Instituto de Salud Carlos III, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain (GRID:grid.5924.a) (ISNI:0000000419370271)
14 Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Harvard T.H. Chan School of Public Health, Departments of Epidemiology and Statistics, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Brigham and Women’s Hospital and Harvard Medical School, Channing Division for Network Medicine, Department of Medicine, Boston, USA (GRID:grid.62560.37) (ISNI:0000 0004 0378 8294)