Abstract
Ultra-processed food (UPF) consumption has been associated with higher risks of diabetic microvascular complications. However, whether a metabolite profile related to UPF consumption reflects these associations was unknown. Using data from the UK Biobank (a prospective cohort study), a metabolomic signature comprising 14 metabolites was derived and robustly correlated with UPF consumption. Compared with UPF consumption, its corresponding metabolomic signature was also associated with higher risks of composite microvascular complications and diabetic kidney disease, with an additionally identified significant association with diabetic retinopathy and diabetic neuropathy. The above associations between the metabolomic signature and diabetic microvascular complications remained significant after further adjustment for UPF consumption. Three metabolites from lipid components of VLDL and HDL, MUFA, albumin, and glycoprotein acetyls mediated the association between UPF intake and composite microvascular complications. These findings suggest that the metabolomic signature has the potential to stratify individuals with different dietary responses to UPFs and facilitate personalized nutrition for individuals with type 2 diabetes.</p>