The relationship between plasma sphingosine-1-phosphate, plasma apolipoprotein M, obesity, and the risk of incident type 2 diabetes: a prospective cohort study.

Abstract

Type 2 diabetes (T2D) is a growing global health challenge, necessitating novel biomarkers for early risk assessment. This study investigates the associations between plasma sphingosine-1-phosphate (S1P), apolipoprotein M (ApoM), obesity measures, and the risk of incident T2D. We utilized data from the Taiwan Lifestyle Study, a prospective cohort initiated in 2006. A total of 1207 individuals without diabetes at baseline were included. Abdominal fat distribution was assessed using computed tomography, while plasma S1P and ApoM levels were measured using ELISA. During an average follow-up of 5.93 years, 152 participants developed diabetes. Plasma S1P correlated with visceral, peritoneal, and retroperitoneal fat (all p < 0.001), while ApoM correlated with total, subcutaneous, and visceral fat (all p < 0.001). In adjusted models, plasma S1P significantly predicted diabetes (HR 0.52, 95% CI 0.35-0.77, p = 0.001), whereas plasma ApoM did not (HR 1.16, 95% CI 0.94-1.43, p = 0.170). The predictive model incorporating S1P showed an AUC of 0.7698 and a concordance statistic of 0.7637, outperforming traditional risk factors. Plasma S1P and ApoM are both associated with obesity. However, only plasma S1P is a good predictive biomarker for incident T2D, underscoring its potential for early risk assessment and intervention.