Baseline characteristics of participants with prediabetes stratified by incident diabetes status.

Associations of 168 metabolic biomarkers with risk of diabetes among 13,489 participants with prediabetes.

Hazard ratios (HR) were presented per 1 standard deviation (SD) higher of metabolic biomarker on the natural log scale and were adjusted for age, sex, ethnicity, education, Townsend Deprivation Index, employment status, household income, family history of diabetes, history of CVD, history of hypertension, history of dyslipidemia, history of CLD, history of cancer, body mass index, waist circumference, hip circumference, smoking status, moderate alcohol, healthy diet score, healthy sleep score, physical activity, systolic blood pressure, diastolic blood pressure and glycated hemoglobin A1c. *False discovery rate controlled P < 0.05/168.

Apo-A1, apolipoprotein A1; Apo-B, apolipoprotein B; Apo-LP, apolipoprotein; BCAA, branched-chain amino acid; BMI, body mass index; CVD, cardiovascular disease; CLD, chronic lung disease; DHA, docosahexaenoic acid; FA, fatty acids; HDL, high-density lipoproteins; HDL-D, high-density lipoprotein particle diameter; IDL, intermediate-density lipoproteins; L, large; LA, linoleic acid; LDL, low-density lipoproteins; LDL-D, low-density lipoprotein particle diameter; LP, lipoprotein; M, medium; MUFA, monounsaturated fatty acids; PUFA, polyunsaturated fatty acids; S, small; SFA, saturated fatty acids; VLDL, very-low-density lipoproteins; VLDL-D, very-low-density lipoprotein particle diameter; XL, very large; XS, very small; XXL, extremely large.

The top 20 important variables selected by three machine learning models: (A) supporting vector machine (SVM); (B) extreme gradient boosting (XGBoost); (C) random forest (RF).

The models were adjusted for age, sex, ethnicity, education, Townsend Deprivation Index, employment status, household income, family history of diabetes, history of CVD, history of hypertension, history of dyslipidemia, history of CLD, history of cancer, body mass index, waist circumference, hip circumference, smoking status, moderate alcohol, healthy diet score, healthy sleep score, physical activity, systolic blood pressure, diastolic blood pressure and glycated hemoglobin A1c. CVD, cardiovascular disease; CLD, chronic lung disease. HDL, high-density lipoproteins; IDL, intermediate-density lipoproteins; LDL, low-density lipoproteins; VLDL, very-low-density lipoproteins.

Performance of Cox proportional hazards prediction models for the progression of prediabetes to diabetes.

Survival curves for participants with prediabetes with different risks stratified by the Cox model based on clinical variables and 9 metabolites.

The Cox model divided participants with prediabetes in the test set to two categories (A) and three categories (B) with significant differences in cumulative hazard of diabetes during the follow-up (both P <0.0001).

The distribution of the predictive probability of developing diabetes among participants with prediabetes by incident diabetes status within 1-year (A), 5-year (B), and 10-year (C).