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Simple Sugar can predict risk of Type 2 diabetes and cardiovascular disease


A new study shows that high levels of mannose, a simple sugar component of many natural polysaccharides, is a predictor for developing Type 2 diabetes, cardiovascular disease and progression of diabetic kidney disease.

"We can measure mannose in the blood of subjects and identify if they have an increased risk for future progression of Type 2 diabetes, cardiovascular disease and diabetic kidney dieases", says Adil Mardinoglu, systems biologist at KTH-Royal Institute of Technology, in Stockholm, and fellow at SciLifeLab, the Swedish national center for molecular biosciences with focus on health and environmental research.

Independent of other established risk predictors

The study shows that high baseline mannose levels predict future risk of developing Type 2 diabetes, independent of BMI and other well-established risk factors. It also predicts future risk of cardiovascular disease, including heart failure and total mortality, and is related to future development of diabetic kidney disease and progression of albuminuria.

Kidney disease with increased albumin excretion is associated with increased risk of cardiovascular disease and insulin resistance contributes to this.

"Thus, measuring mannose levels early in individuals with diabetes provided information of future risk of progression of albuminuria and serious diabetic kidney disease development, which may require kidney transplantation", says Professor Ulf Smith, expert in the pathogenesis of insulin resistance and diabetes at Sahlgrenska Academy, University of Gothenburg, and head of the study.
"Diabetic kidney disease is also an important predictor of future risk of cardiovascular disease and early mortality."

The study was made using the large EMIF, Electronic Medical Information Framework, clinical databases to analyse if mannose levels could predict disease development. An earlier EMIF project identified novel biomarkers or causes of obesity-associated complications including development of T2D, CVD, liver complications, certain cancers and dementia. Based on this, an earlier study could show that obesity is associated with a dysregulated metabolism of mannose in the liver and that serum levels of mannose were elevated. The study also showed that mannose levels identified individuals with increased degree of insulin resistance independent of BMI (published in Cell Metabolism July 23, 2016).

Disease development after up to 8 years

In the new study, the researchers wanted to analyze if mannose levels also predicted disease development. They analyzed mannose with specific liquid chromatography- mass spectrometry in relation to future development (after up to 8 years) of Type 2 diabetes, cardiovascular disease and diabetic kidney disease in a total of over 8,000 individuals who did not have disease at the time of the baseline mannose levels.

"At present, it is unclear if, or how, mannose contributes to disease development but recent advances have shown that mannose may be involved in the body’s immune regulation and other basic mechanisms for normal cell growth and function", says Professor Ulf Smith. 

The study was sponsored by EMIF, the Electronic Medical Information Framework, a large European database built to allow analysis of disease development and factors predicting disease risk. EMIF was initiated in 2013 as part of the Innovative Medicines Initiative, IMI, a collaboration between EU and the European pharmaceutical industry association, EFPIA.

Read the article in Cell Metabolism


Ulf Smith, Professor

+46 70 655 3518

Adil Mardinoglu, Assistant Professor

+46 73 638 8001