Beulens Joline W J, Rimm Eric B, Hu Frank B, Hendriks Henk F J, Mukamal Kenneth J
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Diabetes Care. 2008 Oct;31(10):2050-5. doi: 10.2337/dc08-0814. Epub 2008 Jul 15.
The purpose of this study was to investigate whether adiponectin concentrations and biomarkers of inflammation, endothelial dysfunction, and insulin resistance mediate the association between alcohol consumption and diabetes.
In a nested case-control study of 705 women with incident diabetes and 787 matched control subjects, we examined the adjusted relationship between baseline alcohol consumption and risk of diabetes before and after adjustment for markers of inflammation/endothelial dysfunction (C-reactive protein, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin, tumor necrosis factor-alpha receptor 2, and interleukin-6), fasting insulin, and adiponectin concentrations.
Alcohol consumption was associated with a decreased risk of diabetes (odds ratio per 12.5 g/day increment in alcohol use 0.58; 95% CI 0.49-0.69; P < 0.001). Adjustment for BMI attenuated the association by 25%. None of the markers of inflammation or fasting insulin appeared to account for >2% of the observed relationship. Without adjustment for BMI, these biomarkers individually explained slightly more of the association, but <10% in all cases. Adiponectin accounted for 25% in a fully adjusted model and for 29% without adjustment for BMI.
In this population of women, alcohol consumption was inversely associated with risk of type 2 diabetes. Adiponectin appeared to be a mediator of this association, but circulating biomarkers of inflammation, endothelial dysfunction, and fasting insulin did not explain this association. These results suggest that further research is needed into the potentially mediating roles of other biomarkers affected by alcohol consumption.
本研究旨在探讨脂联素浓度以及炎症、内皮功能障碍和胰岛素抵抗的生物标志物是否介导饮酒与糖尿病之间的关联。
在一项对705例新发糖尿病女性和787例匹配对照进行的巢式病例对照研究中，我们在调整炎症/内皮功能障碍标志物（C反应蛋白、血管细胞黏附分子-1、细胞间黏附分子-1、E选择素、肿瘤坏死因子-α受体2和白细胞介素-6）、空腹胰岛素和脂联素浓度前后，研究了基线饮酒量与糖尿病风险之间的校正关系。
饮酒与糖尿病风险降低相关（酒精摄入量每增加12.5克/天，比值比为0.58；95%可信区间为0.49 - 0.69；P < 0.001）。调整体重指数后，这种关联减弱了25%。炎症标志物或空腹胰岛素均未显示能解释观察到的关联的>2%。在未调整体重指数的情况下，这些生物标志物各自对关联的解释略多，但在所有情况下均<10%。在完全调整模型中，脂联素占25%，在未调整体重指数时占29%。
在这群女性中，饮酒与2型糖尿病风险呈负相关。脂联素似乎是这种关联的一个介导因素，但炎症、内皮功能障碍和空腹胰岛素的循环生物标志物并不能解释这种关联。这些结果表明，需要进一步研究受饮酒影响的其他生物标志物的潜在介导作用。
