Institute of Health Studies, Barcelona 08005, Spain.
Ann Med. 2013 Feb;45(1):97-102. doi: 10.3109/07853890.2012.679958. Epub 2012 Apr 13.
To investigate the relationship of body mass index and serum adipokines with incidence of diabetes in men.
Ten-year cohort study of a random population sample of 1011 men aged 35-69 years from the MONICA-Catalonia survey (1986-1988). WHO-MONICA protocol and the US Hispanic NHANES diabetes questionnaire were applied. Fasting serum glucose and lipids were measured by enzymatic methods, adipokines and insulin by Luminex xMAP technology,and hs-CRP by nephelometry in stored baseline samples (-80°C). Type2 diabetes was defined as fasting glucose ≥ 7.0 mmol/L or diagnosed diabetes. Incident diabetes was defined as absence of these criteria at baseline but presence at re-examination. Cox regression analysis was used.
Incidence of diabetes (n = 85) was 10.3/1000 person-years, increasing significantly with BMI but decreasing by quartiles of adiponectin. Incidence increased above median BMI and glucose (45.3/1000 person-years, OR = 19.97). Log-adiponectin associated with reduced risk of diabetes after multivariate adjustment (HR = 0.24, 95% CI 0.08-0.72), with significant modification of this effect by baseline glycaemia. C-reactive protein was not a significant factor. Leptin lost strength when adjusted for BMI.
In a population with relatively high diabetes incidence, BMI and glucose were strong risk factors, while adiponectin protected against diabetes, especially in men with high glycaemic level.
研究人体质量指数(BMI)和血清脂肪因子与男性糖尿病发病的关系。
这是一项为期 10 年的队列研究,对象为 MONICA-加泰罗尼亚调查(1986-1988 年)中随机抽取的 1011 名 35-69 岁男性的人群样本。采用世界卫生组织- MONICA 方案和美国西班牙裔 NHANES 糖尿病问卷。空腹血清葡萄糖和脂质采用酶法测定,脂肪因子和胰岛素采用 Luminex xMAP 技术,hs-CRP 采用散射比浊法在储存的基线样本(-80°C)中测定。2 型糖尿病定义为空腹血糖≥7.0mmol/L 或确诊糖尿病。新发糖尿病定义为基线时无这些标准但复查时存在。采用 Cox 回归分析。
糖尿病(n=85)的发病率为 10.3/1000 人年,随 BMI 显著增加,但随脂联素四分位数降低而降低。发病率在中位数 BMI 和葡萄糖以上增加(45.3/1000 人年,OR=19.97)。经多变量校正后,log 脂联素与糖尿病风险降低相关(HR=0.24,95%CI 0.08-0.72),基础血糖水平对此效应有显著修饰作用。C 反应蛋白不是一个重要因素。当调整 BMI 后,瘦素的作用减弱。
在糖尿病发病率相对较高的人群中,BMI 和葡萄糖是强有力的危险因素,而脂联素可预防糖尿病,尤其是在血糖水平较高的男性中。