Fig. 1: The analytic framework of the study.

Eligible UKB participants were split into population-I for evaluating the prospective association of RPET with future T2DM (phase-I analysis) and identifying RPET metabolic fingerprints (phase-II analysis); and population-II for evaluating the prospective association of the RPET metabolic fingerprints with future risk of T2DM, as well as their incremental predictive value and clinical utility (phase-III analysis). Additional GDES population was employed to investigate the association between average RPET with future diabetic microvascular phenotypes, and the potential of RPET metabolic fingerprints in facilitating risk stratification for these outcomes (phase-IV analysis). UKB UK Biobank, GDES Guangzhou Diabetes Eye Study; RPET retinal pigment epithelium thickness; T2DM type 2 diabetes mellitus; LC/MS Liquid Chromatography/Mass Spectrometry.