<b>Objective:</b> Type 2
diabetes develops for many years before diagnosis. We aimed to reveal early
metabolic features characterising liability to adult disease by examining
genetic liability to adult type 2 diabetes in relation to metabolomic traits
across early life.
<p><b>Research Design
and Methods:</b> <a>Up to 4,761 offspring from the
Avon Longitudinal Study of Parents and Children</a> were studied. Linear models
were used to examine effects of a genetic risk score (162 variants) for adult type
2 diabetes on 229 metabolomic traits (lipoprotein-subclass-specific cholesterol
and triglycerides, amino acids, glycoprotein acetyls, others) measured at age
8y, 16y, 18y, and 25y. Two-sample Mendelian randomization (MR) was also conducted
using genome-wide association study data on metabolomic traits in an
independent sample of 24,925 adults. </p>
<p><b>Results:</b> At age
8y, associations were most evident for type 2 diabetes liability (per
SD-higher) with lower lipids in high-density lipoprotein (HDL) subtypes, e.g. -0.03
SD (95% CI=-0.06, -0.003) for total lipids in very-large HDL. At 16y,
associations were stronger with pre-glycemic traits including citrate and with
glycoprotein acetyls (0.05 SD, 95% CI=0.01, 0.08), and at 18y, associations
were stronger with branched chain amino acids. At 25y, associations had
strengthened with VLDL lipids and remained consistent with previously altered
traits including HDL lipids. Two-sample MR estimates among adults indicated persistent
patterns of effect of disease liability. </p>
<p><b>Conclusions:</b> Our
results support perturbed HDL lipid metabolism as one of the earliest features
of <a>type 2 diabetes liability, alongside higher branched
chain amino acid and inflammatory levels. Several features are apparent in
childhood as early as age 8y, decades before the clinical onset of disease. </a></p>