Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
Diabet Med. 2010 Sep;27(9):1004-11. doi: 10.1111/j.1464-5491.2010.03043.x.
Adipocyte-derived hormones seem to be involved in the development of Type 2 diabetes. Therefore, we assessed the association between the proinflammatory adipokine leptin and incident Type 2 diabetes, taking into account interactions between leptin and the anti-inflammatory adipokine adiponectin.
Using a case-cohort design, serum levels of adipokines were measured in 460 cases with incident Type 2 diabetes and 1474 non-cases selected from a source population of 7936 middle-aged subjects participating in the population-based Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) Augsburg cohort study between 1984 and 1995 and followed up until 2002 (mean follow-up 10.9+/-4.7 years).
High leptin and low adiponectin levels were associated with an increased Type 2 diabetes risk. The multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) comparing tertile extremes were 1.71 (1.12-2.63) for leptin (top vs. bottom tertile) and 2.65 (1.88-3.76) for adiponectin (bottom vs. top tertile), respectively. There was a significant interaction between leptin and adiponectin, with highest diabetes risk being observed in individuals with high leptin and low adiponectin levels (P = 0.029 for interaction).While the addition of adiponectin to a basic risk factor model improved model prediction (Delta area under the curve 0.011), the change in model prediction was only marginal after the addition of leptin (Delta area under the curve 0.002).
Our findings indicate that the two adipokines leptin and adiponectin interact in modulating Type 2 diabetes risk, but adiponectin is more strongly associated with Type 2 diabetes risk than leptin.
脂肪细胞衍生激素似乎参与了 2 型糖尿病的发生。因此，我们评估了促炎脂肪因子瘦素与 2 型糖尿病发病之间的关系，同时考虑了瘦素与抗炎脂肪因子脂联素之间的相互作用。
采用病例-队列设计，在 1984 年至 1995 年期间参加基于人群的心血管疾病趋势和决定因素监测（MONICA）/奥格斯堡合作健康研究（KORA）奥格斯堡队列研究的 7936 名中年受试者的源人群中，选取 460 例新诊断的 2 型糖尿病患者和 1474 例非病例作为对照，并随访至 2002 年（平均随访 10.9+/-4.7 年）。
高瘦素和低脂联素水平与 2 型糖尿病风险增加相关。多变量调整后的风险比（HR）和 95%置信区间（CI）比较三分类极值的结果为，瘦素（最高 vs. 最低三分位数）为 1.71（1.12-2.63），脂联素（最低 vs. 最高三分位数）为 2.65（1.88-3.76）。瘦素和脂联素之间存在显著的交互作用，高瘦素和低脂联素水平的个体糖尿病风险最高（交互作用 P = 0.029）。虽然脂联素的加入可提高基本风险因素模型的预测能力（曲线下面积增加 0.011），但瘦素的加入仅使模型预测略有改变（曲线下面积增加 0.002）。
我们的研究结果表明，两种脂肪因子瘦素和脂联素在调节 2 型糖尿病风险方面存在相互作用，但脂联素与 2 型糖尿病风险的相关性强于瘦素。
