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dc.contributor.advisorBerg, Vivian
dc.contributor.authorAllaoui, Giovanni
dc.date.accessioned2023-11-09T13:41:59Z
dc.date.available2023-11-09T13:41:59Z
dc.date.issued2023-11-24
dc.description.abstractType 2 diabetes (T2DM) is a chronic metabolic disease and is characterised by insulin resistance and insufficient insulin secretion, resulting in hyperglycaemia. The prevalence of diabetes was estimated to be 10.5% in 2021, globally. T2DM is associated with several complications, including cardiovascular complications, degradation of nerve fibres and eyesight, and impaired kidney function, especially if left untreated. The aim is to investigate blood biomarkers related to metabolic processes (lipid, glucose, and hormone homeostasis) and their association with T2DM. Comparing pre- and post-diagnostic concentrations of blood biomarkers between T2DM cases and healthy controls will advance our knowledge of potential early predictors of T2DM and incentivise early implementations of intervention in a primary healthcare setting. This thesis adopted a longitudinal nested case-control study based on the Tromsø Study. Participants who attended three to five surveys in the period 1986–2016 were included, where the cases were diagnosed with T2DM between the third and fourth survey. The blood biomarkers were analysed in serum samples, collected at the time of each survey. Several statistical methodologies were used to assess the associations between blood biomarkers and T2DM, and to compare how they changed over time between cases and controls and how well they could discriminate between the two groups. Our study findings highlighted notable associations between several blood biomarkers implicated in lipid, glucose, and hormone homeostasis and the risk of developing T2DM long before the diagnosis. By utilising a combination of lipids and glycaemic biomarkers in addition to established non-invasive risk factors, it was possible to successfully identify individuals with an increased risk of developing T2DM as early as 15 years before the diagnosis. This emphasises the importance of early implementation of preventive measures to avoid or delay the onset of T2DM.en_US
dc.description.doctoraltypeph.d.en_US
dc.description.popularabstractIt is estimated that 10.5% of the world’s population are living with type 2 diabetes, and the number of individuals diagnosed with the disease is increasing. Type 2 diabetes slowly develops over many years and is characterised by a decrease in the effect and production of insulin, which is a hormone that regulates blood sugar levels. This process results in chronically increased blood sugar levels and eventually type 2 diabetes diagnosis. The disease is irreversible and may lead to several complications such as nerve damage, blindness, foot ulcers and amputation, heart disease, kidney disease, and early death. Therefore, it is important to prevent type 2 diabetes from developing as early as possible. This thesis aimed to investigate the associations of several blood biomarkers related to lipid, glucose, and hormone homeostasis with type 2 diabetes, as well as how they change over time. We compared these blood biomarkers in healthy controls with individuals who developed type 2 diabetes and followed what has happened 15 years before diagnosis as well as what happened 15 years after, with three to five repeated measurements. The results revealed that the individuals who developed type 2 diabetes had different and more adverse levels of several of the biomarkers compared to healthy controls for up to 15 years before diagnosis. These results shows that blood biomarkers can successfully be used to evaluate if individuals are at risk of developing diabetes type 2 in the future.en_US
dc.description.sponsorshipHelse Nord (The Northern Norway Regional Health Authority; project number HNF1470-19).en_US
dc.identifier.urihttps://hdl.handle.net/10037/31718
dc.language.isoengen_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.relation.haspart<p>Paper I: Allaoui, G., Rylander, C., Averina, M., Wilsgaard, T., Fuskevåg, O.M. & Berg, V. (2022). Longitudinal changes in blood biomarkers and their ability to predict type 2 diabetes mellitus-The Tromsø study. <i>Endocrinology, Diabetes & Metabolism, 5</i>(2), e00325. Also available in Munin at <a href=https://hdl.handle.net/10037/26521>https://hdl.handle.net/10037/26521</a>. <p>Paper II: Allaoui, G., Rylander, C., Fuskevåg, O.M., Averina, M., Wilsgaard, T., Brustad, M., Jorde, R. & Berg, V. (2023). Longitudinal changes in vitamin D concentrations and the association with type 2 diabetes mellitus: the Tromsø Study. <i>Acta Diabetologica, 60</i>, 293–304. Also available in Munin at <a href=https://hdl.handle.net/10037/28212>https://hdl.handle.net/10037/28212</a>. <p>Paper III: Allaoui, G., Rylander, C., Fuskevåg, O.M., Grimnes, G., Averina, M., Wilsgaard, T. & Berg, V. (2023). Longitudinal assessment of classic and 11-oxygenated androgen concentrations and their association with the development of type 2 diabetes – the Tromsø Study. (Submitted manuscript). Now published in <i>Acta Diabetologica</i>, 2024, available at <a href=https://doi.org/10.1007/s00592-024-02266-5>https://doi.org/10.1007/s00592-024-02266-5</a>.en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0en_US
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Medisinsk biokjemi: 726en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Medical biochemistry: 726en_US
dc.titleBlood biomarkers and Type 2 Diabetes Mellitus - Repeated measurements of blood biomarkers in Type 2 Diabetes Mellitus cases and controls; longitudinal assessments and associationsen_US
dc.typeDoctoral thesisen_US
dc.typeDoktorgradsavhandlingen_US


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