Association of serum total fatty acids with type 2 diabetes

Background: Type 2 diabetes (T2D), a typical metabolic disease, is closely associated with serum free fatty acids. But the association between serum total fatty acids (TFAs, free fatty acids plus esterified fatty acids) and T2D has not been reported. Methods: Serum esterified fatty acids were hydrolyzed under alkaline conditions, and serum TFAs were extracted after acidizing. Fourteen of serum TFAs in 1,828 serum samples, including 543 controls, 655 prediabetes, and 630 T2D patients, were simultaneously quantified based on the calibration curves of 8 fatty acids using matrix-assisted laser desorption/ionization-Fourier transform ion cyclotron resonance mass spectrometry (MALDI-FTICR MS). Results: Correlation analysis revealed strong correlations among serum TFAs and ratios of the TFAs in T2D patients compared with controls or prediabetes both in males and females. Receiver operating characteristic analysis indicated that a panel including fasting plasma glucose, glycosylated hemoglobin type A1c, gammaglutamyltransferase, triglyceride, C18:1, and C20:3, has a good capability to distinguish prediabetes from T2D, with the sensitivity of 87.0%, the specificity of 91.0%, and the area under curve (AUC) of 0.96. Conclusions: In this study, rapid, absolute, and simultaneous quantification of serum TFAs was performed using MALDI-FTICR MS. C18:1 and C20:3 were significantly correlated with prediabetes and T2D.