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Here, we extend prior work by analyzing a large cohort of self-identified African Americans in the Jackson Heart Study (n = 1,313). We found 325 proteins associated with incident diabetes after adjusting for age, sex, and sample batch (false discovery rate q &amp;lt; 0.05) measured using a single-stranded DNA aptamer affinity-based method on fasting plasma samples. A subset was independent of established markers of diabetes development pathways, such as adiposity, glycemia, and\/or insulin resistance, suggesting potential novel biological processes associated with disease development. Thirty-six associations remained significant after additional adjustments for BMI, fasting plasma glucose, cholesterol levels, hypertension, statin use, and renal function. Twelve associations, including the top associations of complement factor H, formimidoyltransferase cyclodeaminase, serine\/threonine\u2013protein kinase 17B, and high-mobility group protein B1, were replicated in a meta-analysis of two self-identified White cohorts\u2014the Framingham Heart Study and the Malm\u00f6 Diet and Cancer Study\u2014supporting the generalizability of these biomarkers. A selection of these diabetes-associated proteins also improved risk prediction. Thus, we uncovered both novel and broadly generalizable associations by studying a diverse population, providing a more complete understanding of the diabetes-associated proteome.<\/jats:p>","DOI":"10.2337\/db22-0710","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T13:52:53Z","timestamp":1673445173000},"page":"532-543","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":18,"title":["Protein Markers of Diabetes Discovered in an African American Cohort"],"prefix":"10.2337","volume":"72","author":[{"given":"Zsu-Zsu","family":"Chen","sequence":"first","affiliation":[{"name":"1Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Boston, MA"},{"name":"2Harvard School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Gao","sequence":"additional","affiliation":[{"name":"3Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J.","family":"Keyes","sequence":"additional","affiliation":[{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuliang","family":"Deng","sequence":"additional","affiliation":[{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mi","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie A.","family":"Farrell","sequence":"additional","affiliation":[{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxiao","family":"Shen","sequence":"additional","affiliation":[{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman A.","family":"Tahir","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Cruz","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debby","family":"Ngo","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"5Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Benson","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Robbins","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Correa","sequence":"additional","affiliation":[{"name":"3Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Wilson","sequence":"additional","affiliation":[{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6767-7687","authenticated-orcid":false,"given":"Robert E.","family":"Gerszten","sequence":"additional","affiliation":[{"name":"2Harvard School of Medicine, Boston, MA"},{"name":"4Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA"},{"name":"6Broad Institute of MIT and Harvard, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"2023032018540258600_","unstructured":"World Health Organization . 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