Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies

Abstract Background Amino acid (AA) intake is thought to be closely related to the etiology of type 2 diabetes (T2D), although few prospective human studies have examined the association. The study prospectively examined inter-relationships among the intake of all 20 AAs, blood metabolome, and T2D i...

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Main Authors: Siyue Wang, Yanping Li, Molin Wang, Jeffrey Yuan, Oana A. Zeleznik, A. Heather Eliassen, Andrew T. Chan, Frank B. Hu, Yang Hu, Qi Sun
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Nutrition Journal
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Online Access:https://doi.org/10.1186/s12937-025-01157-x
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author Siyue Wang
Yanping Li
Molin Wang
Jeffrey Yuan
Oana A. Zeleznik
A. Heather Eliassen
Andrew T. Chan
Frank B. Hu
Yang Hu
Qi Sun
author_facet Siyue Wang
Yanping Li
Molin Wang
Jeffrey Yuan
Oana A. Zeleznik
A. Heather Eliassen
Andrew T. Chan
Frank B. Hu
Yang Hu
Qi Sun
author_sort Siyue Wang
collection DOAJ
description Abstract Background Amino acid (AA) intake is thought to be closely related to the etiology of type 2 diabetes (T2D), although few prospective human studies have examined the association. The study prospectively examined inter-relationships among the intake of all 20 AAs, blood metabolome, and T2D incidence. Methods Prospective associations between 20 individual AA intake and T2D were examined among 201,113 participants from the Health Professionals Follow-up Study (HPFS), Nurses’ Health Study (NHS), and NHSII who did not have T2D, cardiovascular disease, or cancer at baseline. Next, a multi-metabolite signature responsive to AA intake was derived through two sets of 7-day diet record (7DDR) assessments, and subsequently replicated in multiple cohorts. Finally, Cox regression models were used to determine and confirm the prospective associations of AA intake, plasma metabolite signatures, with T2D incidence. Results During 5,037,848 person-years of follow-up, 20,619 T2D cases were documented. Sulfur AAs (SAAs) and aromatic amino acids were significantly associated with higher T2D risk independent of other AAs. Comparing the highest with lowest quintiles of intake, the multivariable adjusted pooled hazard ratios (HRs) for T2D were 1.20 (95% CI: 1.13–1.27) for total SAA (P  for trend < 0.0001) and 1.14 (95% CI: 1.08–1.21) for total aromatic AAs (P  for trend < 0.0001). A total of 73 plasma metabolites were identified as responsive markers for total SAA intake, and 87 metabolites for total aromatic AA intake. Approximately 75% of these metabolites were commonly responsive within the individual AAs within the same class. The multi-metabolite signatures for SAAs and aromatic AAs intakes were replicated in an independent study [β = 0.30 or 0.31 per SD increase of SAA and aromatic AA intake, respectively, P < 0.0001 for both associations). Moreover, the signatures were associated with T2D incidence: the HRs for per SD change were 1.14 (95%CI: 1.08–1.20, P < 0.00001) for SAA signature and 1.18 (95%CI: 1.12–1.24, P < 0.00001) for aromatic AA signature. Mediation analysis showed that the metabolite signatures explained various degree (% ranging from 10.5(95%CI: 3.8–26.1) to 29.9(95%CI: 13.5–53.9)) for the associations between dietary SAAs/aromatic AAs and T2D incidence risk. Conclusions This study provides novel evidence that higher intake of sulfur and aromatic AAs is independently associated with an increased risk of T2D. Multiple plasma metabolites are responsive to these dietary AAs, potentially serving as objective markers for AA intake. Collectively, the metabolite signatures significantly predict a higher T2D risk, and mediate the positive associations to various degrees, corroborating findings from long-term dietary assessments.
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spelling doaj-art-c9fce2e95802410ebdf2a5586e95530e2025-08-20T04:01:46ZengBMCNutrition Journal1475-28912025-07-0124111710.1186/s12937-025-01157-xAmino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studiesSiyue Wang0Yanping Li1Molin Wang2Jeffrey Yuan3Oana A. Zeleznik4A. Heather Eliassen5Andrew T. Chan6Frank B. Hu7Yang Hu8Qi Sun9Department of Nutrition, Harvard T.H. Chan School of Public HealthDepartment of Nutrition, Harvard T.H. Chan School of Public HealthDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthDepartment of Nutrition, Harvard T.H. Chan School of Public HealthChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical SchoolDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthClinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General HospitalDepartment of Nutrition, Harvard T.H. Chan School of Public HealthDepartment of Nutrition, Harvard T.H. Chan School of Public HealthDepartment of Nutrition, Harvard T.H. Chan School of Public HealthAbstract Background Amino acid (AA) intake is thought to be closely related to the etiology of type 2 diabetes (T2D), although few prospective human studies have examined the association. The study prospectively examined inter-relationships among the intake of all 20 AAs, blood metabolome, and T2D incidence. Methods Prospective associations between 20 individual AA intake and T2D were examined among 201,113 participants from the Health Professionals Follow-up Study (HPFS), Nurses’ Health Study (NHS), and NHSII who did not have T2D, cardiovascular disease, or cancer at baseline. Next, a multi-metabolite signature responsive to AA intake was derived through two sets of 7-day diet record (7DDR) assessments, and subsequently replicated in multiple cohorts. Finally, Cox regression models were used to determine and confirm the prospective associations of AA intake, plasma metabolite signatures, with T2D incidence. Results During 5,037,848 person-years of follow-up, 20,619 T2D cases were documented. Sulfur AAs (SAAs) and aromatic amino acids were significantly associated with higher T2D risk independent of other AAs. Comparing the highest with lowest quintiles of intake, the multivariable adjusted pooled hazard ratios (HRs) for T2D were 1.20 (95% CI: 1.13–1.27) for total SAA (P  for trend < 0.0001) and 1.14 (95% CI: 1.08–1.21) for total aromatic AAs (P  for trend < 0.0001). A total of 73 plasma metabolites were identified as responsive markers for total SAA intake, and 87 metabolites for total aromatic AA intake. Approximately 75% of these metabolites were commonly responsive within the individual AAs within the same class. The multi-metabolite signatures for SAAs and aromatic AAs intakes were replicated in an independent study [β = 0.30 or 0.31 per SD increase of SAA and aromatic AA intake, respectively, P < 0.0001 for both associations). Moreover, the signatures were associated with T2D incidence: the HRs for per SD change were 1.14 (95%CI: 1.08–1.20, P < 0.00001) for SAA signature and 1.18 (95%CI: 1.12–1.24, P < 0.00001) for aromatic AA signature. Mediation analysis showed that the metabolite signatures explained various degree (% ranging from 10.5(95%CI: 3.8–26.1) to 29.9(95%CI: 13.5–53.9)) for the associations between dietary SAAs/aromatic AAs and T2D incidence risk. Conclusions This study provides novel evidence that higher intake of sulfur and aromatic AAs is independently associated with an increased risk of T2D. Multiple plasma metabolites are responsive to these dietary AAs, potentially serving as objective markers for AA intake. Collectively, the metabolite signatures significantly predict a higher T2D risk, and mediate the positive associations to various degrees, corroborating findings from long-term dietary assessments.https://doi.org/10.1186/s12937-025-01157-xAmino acidType 2 diabetesCohort studyNutritional epidemiology
spellingShingle Siyue Wang
Yanping Li
Molin Wang
Jeffrey Yuan
Oana A. Zeleznik
A. Heather Eliassen
Andrew T. Chan
Frank B. Hu
Yang Hu
Qi Sun
Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies
Nutrition Journal
Amino acid
Type 2 diabetes
Cohort study
Nutritional epidemiology
title Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies
title_full Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies
title_fullStr Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies
title_full_unstemmed Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies
title_short Amino acid intake, plasma metabolites, and incident type 2 diabetes risk: a systematic approach in prospective cohort studies
title_sort amino acid intake plasma metabolites and incident type 2 diabetes risk a systematic approach in prospective cohort studies
topic Amino acid
Type 2 diabetes
Cohort study
Nutritional epidemiology
url https://doi.org/10.1186/s12937-025-01157-x
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