Summary: In a new study, researchers found that IF1 is a reliable mitochondrial biomarker. Low levels are associated with higher diabetes risk. People with worse mitochondrial dysfunction (failing cell power plants) are more likely to get diabetes. So in the future, IF1 can be used to predict diabetes risk.
One-third of adults in the US have prediabetes. But some of them are more likely to move on to diabetes than others. The diabetes pandemic has run for decades and shows no sign of fading. In fact, the number of people with diabetes is rising fast. About 10.5% of people in the US already have diabetes. Worse, another 30% are on the edge of it. These are the people with prediabetes. Diabetes raises the risk of heart disease, stroke, kidney failure, and more. It is among the top 10 causes of illness and death. It also causes major disability and a huge burden on the health system. Type 2 diabetes comes from years of neglect, too many calories, too little movement, obesity, and more. Still, researchers have seen that not everyone with prediabetes gets diabetes. Some people are more likely to cross over than others. So how can doctors know who is at greater risk? Say two people with prediabetes have the same age, weight, and lifestyle. Why does one get diabetes and the other does not? Doctors now understand diabetes and prediabetes better at the level of the cell. They have learned that mitochondrial dysfunction plays a big role in insulin resistance. Mitochondria are the power plants inside your cells. Their failure is now a hot topic in diabetes, brain disorders, mental health problems, and other metabolic disease. Lab studies confirm mitochondrial dysfunction in many chronic diseases. But measuring it in the clinic is hard. Now researchers seem to have found a way. They found a reliable biomarker (a measurable signal in the blood) of how mitochondria make energy. It seems the level of ATPase inhibitory factor 1 (IF1) drops when mitochondria fail. So people with prediabetes are more likely to get diabetes if they have low IF1 plasma levels. The new IT-DIAB study followed 307 people with prediabetes for 5 years. Those with low IF1 levels were more likely to progress to diabetes. After five years, 115 people (37%) had developed diabetes. Those who got diabetes had an IF1 plasma level of 537 ng/mL. Those who did not had 621 ng/mL. The study was small. Still, it is the first of its kind to show that a mitochondrial biomarker can predict diabetes risk in prediabetes. Researchers say it matters despite the small size. Now they can build on it with larger studies. In the future, this biomarker may become a reliable way to predict diabetes risk. Such biomarkers may also help predict many other metabolic disorders. After all, it is no secret that failing mitochondria play a role in many other diseases. This biomarker may also help find better ways to manage mitochondrial dysfunction, and so prevent many diseases.
Related reading on painmd.tv
Frequently asked questions
What is the relationship between type 2 diabetes and mitochondrial dysfunction?
Mitochondria are the power plants inside your cells. When they stop turning fuel into energy, cells stop answering insulin the way they should. That insulin resistance is the road to type 2 diabetes. The more mitochondrial dysfunction a person carries, the more likely they are to get diabetes. The same breakdown shows up in brain disorders, mental health problems, and other metabolic disease.
What is IF1, and what does a low IF1 level mean?
IF1, short for ATPase inhibitory factor 1, is a protein in the blood. It tracks how well your mitochondria make energy. Its level falls as mitochondria fail. In the IT-DIAB study, people with prediabetes who went on to get diabetes had an IF1 plasma level of 537 ng/mL. Those who did not had 621 ng/mL. Low IF1 flags the higher-risk group.
What percentage of people with prediabetes develop type 2 diabetes?
Not all of them, and that is the point. In IT-DIAB, researchers followed 307 people with prediabetes for five years. Of them, 115, or 37%, got diabetes. The rest did not. One-third of US adults have prediabetes. Knowing who is headed for diabetes tells doctors where to spend their effort first.
Why do some people with prediabetes get diabetes and others do not?
Two people can share the same age, weight, and habits, and only one of them gets diabetes. Weight and lifestyle do not explain that gap. The answer is coming from inside the cell. The person whose mitochondria are failing, and whose IF1 level is low, is more likely to cross the line into diabetes.
Can a blood test predict who will get type 2 diabetes?
Not yet as a routine test. IT-DIAB was small. It is the first study of its kind to use a mitochondrial biomarker to predict diabetes in people with prediabetes. Researchers now need larger studies. If the results hold, IF1 could become a reliable way to measure diabetes risk. It may help predict other metabolic disorders too.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
