Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA.
Diabetes Care. 2010 Apr;33(4):804-10. doi: 10.2337/dc09-1679. Epub 2010 Jan 22.
Many studies have documented associations between inflammation and type 2 diabetes incidence. We assessed potential variability in this association in the major U.S. racial/ethnic groups.
Incident type 2 diabetes was assessed among men and women aged 45-84 years without prior clinical cardiovascular disease or diabetes in the prospective Multi-Ethnic Study of Atherosclerosis. Interleukin (IL)-6, fibrinogen, and C-reactive protein (CRP) were measured at baseline (2000-2002); fasting glucose and diabetes medication use was assessed at baseline and three subsequent in-person exams through 2007. Type 2 diabetes was defined as use of diabetes drugs or glucose > or =126 mg/dl. Covariates included baseline demographics, clinic, smoking, alcohol, exercise, hypertension medication, systolic blood pressure, insulin resistance, and BMI. Cox proportional hazards regression was used to calculate hazard ratios (HRs) by quartiles of CRP, IL-6, and fibrinogen.
Among 5,571 participants (mean age 61.6 years, 53% female, 42.1% white, 11.5% Chinese, 25.7% black, and 20.7% Hispanic), 410 developed incident diabetes during a median follow-up time of 4.7 years (incidence 16.8 per 1,000 person-years). CRP, IL-6, and fibrinogen levels were associated with incident diabetes in the entire sample. After adjustment, the associations were attenuated; however, quartile 4 (versus quartile 1) of IL-6 (HR 1.5 [95% CI 1.1-2.2]) and CRP (1.7 [1.3-2.4]) remained associated with incident diabetes. In stratified analyses, similar associations were observed among white, black, and Hispanic participants.
Higher levels of inflammation predict short-term incidence of type 2 diabetes in a multiethnic American sample.
许多研究都记录了炎症与 2 型糖尿病发病之间的关联。我们评估了这种关联在美国主要种族/族裔群体中的潜在差异。
前瞻性的动脉粥样硬化多民族研究（Multi-Ethnic Study of Atherosclerosis）纳入了年龄在 45-84 岁之间、无既往临床心血管疾病或糖尿病的男性和女性，评估他们的 2 型糖尿病发病情况。在基线（2000-2002 年）时测量白细胞介素（IL）-6、纤维蛋白原和 C 反应蛋白（CRP）；在基线和之后的 3 次面对面检查中（截至 2007 年）评估空腹血糖和糖尿病药物的使用情况。2 型糖尿病的定义为使用糖尿病药物或血糖≥126mg/dl。协变量包括基线人口统计学、临床、吸烟、饮酒、运动、高血压药物、收缩压、胰岛素抵抗和 BMI。使用 Cox 比例风险回归计算 CRP、IL-6 和纤维蛋白原四分位数的危险比（HR）。
在 5571 名参与者（平均年龄 61.6 岁，53%为女性，42.1%为白人，11.5%为中国人，25.7%为黑人，20.7%为西班牙裔）中，410 人在中位随访时间为 4.7 年时发生了 2 型糖尿病发病事件（发病率为每 1000 人年 16.8 例）。CRP、IL-6 和纤维蛋白原水平与整个样本的 2 型糖尿病发病有关。经过调整后，这些关联减弱了；然而，IL-6（四分位 4 与四分位 1 相比）（HR 1.5 [95%CI 1.1-2.2]）和 CRP（1.7 [1.3-2.4]）的四分位 4 仍与 2 型糖尿病发病相关。在分层分析中，在白人、黑人和西班牙裔参与者中也观察到了类似的关联。
在一个多民族的美国样本中，更高的炎症水平预示着 2 型糖尿病的短期发病。
