A new Swedish-led study has identified a blood marker that may show who is at risk of developing type 2 diabetes many years before the disease is typically diagnosed.

Team leader Anders Rosengren, a researcher at the Lund University Diabetes Centre (LUDC), and colleagues, write about their findings in the 7 November issue of Cell Metabolism.

Rosengren says in a press statement:

“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.”

When a person is typically diagnosed with type 2 diabetes, it is highly likely that damage to blood vessels, the eyes and other areas of the body has been under way for some years. Finding a test that can predict this would enable preventive treatment to be put in place to avert or limit the damage.

For their study, Rosengren and colleagues compared insulin-producing beta cells from diabetics with those of non-diabetics, and found the diabetic cells had significantly higher levels of the protein SFRP4, which plays a role in inflammatory processes.

They measured levels of SFRP4 in the blood of non-diabetics three times every three years. They found that 37% of those with higher concentrations of the protein developed diabetes during the study, compared with only 9% of those who had below average levels.

Rosengren says this makes the protein a strong “risk marker” that is in the blood several years before diagnosis.

He and his colleagues found the link with the marker was independent of other known risk factors for type 2 diabetes, such as obesity and age.

They believe this is the first time scientists have pointed to a link between the protein and risk for type 2 diabetes, and the first time that a link has been demonstrated between inflammation in beta cells and diabetes.

Lead author Taman Mahdi, a researcher in Rosengren’s team, says:

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

Rosengren says:

“We have also identified the mechanism for how SFRP4 impairs the secretion of insulin. The marker therefore reflects not only an increased risk, but also an ongoing disease process.”

Speculating on the implications of their findings, Rosengren says the biggest factor is the effect an early test for high diabetes risk may have on people’s motivation to change lifestyle:

“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,” he explains.

And there could also implications for treatment:

“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,” says Rosengren.

Written by Catharine Paddock PhD