This study aimed to identify circulating metabolic biomarkers predictive of type 2 diabetes in young adults. Study included 11,896 individuals from four Finnish cohorts.

Among the strongest predictors of diabetes risk were branched-chained and aromatic amino acids, triglyceride fractions within the largest very-low-density lipoprotein particles (VLDL), linoleic omega-6 fatty acids and free cholesterol in large high-density lipoprotein particles (HDL). A biomarker score (phenylalanine, free cholesterol in large HDL, and the ratio of cholesteryl esters to total lipids in large VLDL) was predictive of the risk for future diabetes in an independent validation cohort. To conclude, metabolic aberrations across multiple molecular pathways are predictive of the long-term risk of type 2 diabetes in young adults.