Multiplex Biomarker Approaches in Type 2 Diabetes Mellitus Research
Type 2 diabetes mellitus is a multifactorial condition resulting in high fasting blood glucose levels. Although its diagnosis is straightforward, there is not one set of biomarkers or drug targets that can be used for classification or personalized treatm
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Introduction Type 2 diabetes mellitus is a complex metabolic disorder resulting from a combination of insulin resistance and insulin deficiency. This type of diabetes accounts for 90 % of the cases worldwide and can be distinguished from type 1 diabetes by the fact that it is not autoimmune in origin. After a marked increase over the last three decades, the prevalence of this disorder has now reached epidemic proportions, with almost 400 million adult cases throughout the world [1]. One reason that has been proposed to account for this increase is a possible epidemiologic transition away from communicable diseases as being the major cause of early death. However, it is also likely that this is due to a transition towards increasingly unhealthy dietary habits and lower levels of physical activity [2, 3]. Therefore, there is an urgent need for the development of early intervention strategies to address the public health, economic, scientific and ethical calls to the individual, as well as the societal and healthcare burdens associated with this disease.
Paul C. Guest (ed.), Multiplex Biomarker Techniques: Methods and Applications, Methods in Molecular Biology, vol. 1546, DOI 10.1007/978-1-4939-6730-8_3, © Springer Science+Business Media LLC 2017
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Susan E. Ozanne et al.
Non-modifiable risk factors
Modifiable risk factors
Sub-optimal early environment Insulin resistance Family history of diabetes Sedentary lifestyle High cholesterol Ethnic background
Risk factors of type 2 diabetes Advanced age
Presence of genetic risk factors
Obesity Excessive fatty food consumption Excessive simple sugar consumption
High blood pressure
Fig. 1 Schematic diagram showing the impact of various risk factors for development of type 2 diabetes. The factors on the right and left are listed as non-modifiable and modifiable, respectively but it should be noted that these are generalizations
To date, type 2 diabetes has been difficult to predict and there is no cure. However, abnormalities in glucose metabolism including states of moderate hyperglycaemia are known to occur well before disease onset [4, 5]. Therefore, availability of a reliable biomarker test for identification prior to development of hyperglycaemia would enable high risk individuals to adopt certain nutritional and physical activity lifestyle changes to delay or even halt progression of the disease [6–8]. In turn, this would help to minimize its impact and improve the long term health outcome of the individual. Known risk factors for type 2 diabetes include advanced age, high body mass index (BMI), poor diet, low physical activity, unfavorable intrauterine environment and certain adverse genetic associations [1, 7, 9–12] (Fig. 1). Molecular studies have also pointed at insulin resistance and knock-on effects in liver, skeletal muscle and adipose tissues as potential predictive markers of type 2 diabetes development [4, 5, 13–15]. Genome Wide Association Studies (GWAS) have identified several genetic risk allele [14]. Many of these are thought to be involve
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