Ketone bodies, molecules produced during the breakdown of fats in the body, are now receiving renewed interest as potential biomarkers of incident type 2 diabetes. But data associating these metabolites to diabetes risk remain less revealed. A recent study published in the journal ‘Diabetes’ that investigated the hidden link between fasting ketone bodies and type 2 diabetes revealed that ketone bodies, either combined or as individual subspecies, are strongly associated with incident type 2 diabetes in the general population, independent of potential confounders.

      The prospective study from the PREVEND cohort included 3,307 participants from the general population initially free of diabetes or impaired fasting glucose. Baseline fasting ketone body concentrations were measured by nuclear magnetic resonance spectroscopy. 126 participants (3.8%) developed type 2 diabetes during a median (interquartile range) follow-up of 7.3 (6.3–7.6) years. Kaplan-Meier analysis emphasized that the sex-stratified ketone body levels are strongly positively associated with incident type 2 diabetes, which was confirmed in Cox regression analyses adjusted for several potential confounders. There was no significant interaction by sex. The analysis also stressed the individual association of both 3-β-hydroxybutyrate and acetoacetate+acetone with incident type 2 diabetes.

      The researchers urged that these results may have important implications for diabetes prevention including dietary strategies.

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