highly significantp = 1.3 × 10 −15
the effect was much stronger than that of the two individual metabolites (Table 4 , ESM Table 19 ; both p ≥ 2.2 × 10 −16 , p gain = 2.2 × 10 11 ). Fasting pairwise metabolite ratios at baseline and incident type 2 diabetes Meta-analysis of the Cox regression results in two independent prospective studies (910 individuals with incident type 2 diabetes and 3367 control participants), with adjustment as shown in ESM Table 10 , shows a highly significant association between the ratio of valine to PC ae C32:2 and type 2 diabetes susceptibility (Table 5 ; HR Val_PC ae C32:2 1.57 [β 0.45 ± 0.06], p = 1.3 × 10 −15 ; the results for the crude models are shown in ESM Table 20 ).