Characterizing metabolomic signatures related to coffee and tea consumption and their association with incidence and dynamic progression of type 2 diabetes: a multi-state analysis

The impact of tea and coffee consumption and related metabolomic signatures on dynamic transitions from diabetes-free status to incident type 2 diabetes (T2D), and subsequently to T2D-related complications and death, was investigated. We included data on 438 970 participants in the UK Biobank who were free of diabetes and diabetes complications at baseline. Of these participants, 212 146 had information on all metabolic biomarkers. We identified tea- and coffee-related metabolomic signatures using elastic net regression models and examined associations of tea and coffee intake and related metabolomic signatures with the onset and progression of T2D, using multistate regression models. Tea and coffee consumption and related metabolomic signatures were inversely associated with the risk of 5 T2D transitions. For example, hazard ratios (95% CIs) per SD increase of the tea-related metabolomic signature were 0.87 (0.85-0.89), 0.97 (0.95-0.99), 0.91 (0.90-0.92), 0.92 (0.91-0.94), and 0.91 (0.90-0.92) for transitions from a diabetes-free state to incident T2D, from a diabetes-free state to all-cause death, from incident T2D to T2D complications, from incident T2D to death, and from T2D complications to death, respectively. These findings highlight the benefit of tea and coffee intake in reducing the risk of occurrence and progression of T2D.