Diabetes Treatment Can Start Earlier

Anders Rosengren, a researcher at the Lund University Diabetes Centre (LUDC) stated that, "We have shown that individuals who have above-average levels of a protein called SFRP4 in the blood are five times more likely to develop diabetes in the next few years than those with below-average levels."

According to researchers, SFRP4 plays a role in inflammatory processes in the body, but this is the first time it has been linked to the risk of type 2 diabetes. It is also the first time inflammation in beta cells and diabetes have been linked.

"The theory has been that low-grade chronic inflammation weakens the beta cells so that they are no longer able to secrete sufficient insulin," said Taman Mahdi, lead author of the study. "There are no doubt multiple reasons for the weakness, but the SFRP4 protein is one of them.

The LUDC studies measured the level of SFRP4 in the blood of non-diabetic patients yearly for three years: 37% of patients who had higher than average SFRP4 levels developed diabetes during the study. Of those who had a lower than average level, 9% developed diabetes. The studies also showed that cells from diabetics have "significantly" higher levels of SFRP4. The protein marker risk factor was demonstrated to work independently from other risk factors, such as obesity and age.

"This makes it a strong risk marker that is present several years before diagnosis. We have also identified the mechanism for how SFRP4 impairs the secretion of insulin," said Rosengren. "The marker therefore reflects not only an increased risk, but also an ongoing disease process."

"If we can point to an increased risk of diabetes in a middle-aged individual of normal weight using a simple blood test, up to ten years before the disease develops, this could provide strong motivation to them to improve their lifestyle to reduce the risk. In the long term, our findings could also lead to new methods of treating type 2 diabetes by developing ways of blocking the protein SFRP4 in the insulin-producing beta cells and reducing inflammation, thereby protecting the cells."

This study was also notable for several other reasons. For example:

The authors discovered how the protein damages insulin secretion which, according to Anders Rosengren, who headed the research, "reflects not only an increased risk, but also an ongoing disease process."

It was the first time scientists found a link between diabetes and inflammation in beta cells. This is important because SFRP4 has been identified as one of the reasons why chronic inflammation prevents beta cells from secreting enough insulin.

Abnormally high SFRP4 levels appear to have an impact on type 2 diabetes risk independent of other known factors, such as age (older than 45) and obesity. Other risk factors for type 2 diabetes include impaired glucose tolerance and/or impaired fasting glucose, a family history of diabetes, sedentary lifestyle, high blood pressure, high triglycerides, low high-density lipoprotein (HDL) cholesterol, and among women, those who have had gestational diabetes.

If this new blood test is able to accurately and effectively warn of an increased risk of type 2 diabetes up to a full decade before the condition develops, this would provide strong motivation to improve lifestyle to reduce the risk.

The blood test also could help researchers find new treatments for type 2 diabetes that involve blocking SFRP4.

Mahdi T et al. Secreted frizzled-related protein 4 reduces insulin secretion and is overexpressed in type 2 diabetes. Cell Metabolism2012 Nov 7; 16(5): 625-33