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

Kang-Chih Fan^{1

2}, I-Weng Yen^{2

3}, Chia-Hung Lin³, Chung-Yi Yang^{4

5}, Chun-Heng Kuo^{2

6

7}, Szu-Chi Chen⁸, Ya-Pin Lyu⁹, Hsien-Chia Juan¹⁰, Mao-Shin Lin¹¹, Shu-Huei Wang¹², Hung-Yuan Li^{13

14}

Affiliations

¹ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
² Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁵ Department of Medical Imaging, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
⁶ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁷ Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
⁸ Department of Internal Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.
⁹ Department of Obstetrics & Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁰ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹¹ Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
¹² Department of Anatomy and Cell Biology, National Taiwan University, Taipei, Taiwan.
¹³ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. larsli@ntuh.gov.tw.
¹⁴ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. larsli@ntuh.gov.tw.

PMID: 40858792
DOI: 10.1038/s41366-025-01890-7

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

Kang-Chih Fan et al. Int J Obes (Lond). 2025.

. 2025 Aug 26.

doi: 10.1038/s41366-025-01890-7. Online ahead of print.

Authors

Affiliations

¹ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
² Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁵ Department of Medical Imaging, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
⁶ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁷ Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
⁸ Department of Internal Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.
⁹ Department of Obstetrics & Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁰ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹¹ Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
¹² Department of Anatomy and Cell Biology, National Taiwan University, Taipei, Taiwan.
¹³ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. larsli@ntuh.gov.tw.
¹⁴ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. larsli@ntuh.gov.tw.

PMID: 40858792
DOI: 10.1038/s41366-025-01890-7

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The study protocol was reviewed and approved by the Institutional Review Board of National Taiwan University Hospital (NTUH-REC No. 202106050RINA). All methods were performed in accordance with the Declaration of Helsinki and relevant guidelines and regulations. Written informed consent to participate was obtained from all individuals before enrollment. This article does not contain any identifiable images or personal data; therefore, no additional consent for publication was required.

References

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources

Miscellaneous