Lee KS, Rim JH, Lee YH, et al. - Findings showed the association of seven metabolites including spermine with incident type 2 diabetes even in obese individuals, indicating potential biomarkers for metabolically healthy obesity. This analysis briefly proposes alanine-to-glycine ratio as a predictive marker for type 2 diabetes in obese people.

• Twelve years of metabolomic data from 2,580 people were used to conduct a metabolomic study to describe metabolically healthy obesity in an obese population (n = 704) with incident type 2 diabetes.

• Following adjustment and correction, spermine, acyl-alkyl phosphatidylcholines (C34:3, C36:3, C42:1), hydroxy sphingomyelin (C22:2, C14:1), and sphingomyelin (C16:0) were found to be linked with incident type 2 diabetes in obese people.

• There was a significant association of 5 metabolites (except hydroxy sphingomyelin C14:1 and sphingomyelin C16:0) with incident type 2 diabetes in lean persons.