Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China.
Obes Rev. 2014 Feb;15(2):134-42. doi: 10.1111/obr.12088. Epub 2013 Sep 15.
This meta-analysis aimed to assess the gender-specific differences in the relationship between circulating leptin levels and risk of type 2 diabetes. Published prospective studies that reported the association of leptin levels with risk of type 2 diabetes for a certain gender or those that reported gender-specific associations were considered. Dose-response relationships were assessed by the generalized least squares trend estimation and summary relative risks (RRs) with 95% confidence interval (CI) were computed with the random-effects model. Stratified and sensitivity analyses were also performed to investigate potential sources of heterogeneity. Overall, 11 prospective studies were identified. The summary RR for an increment in leptin levels of 1-log ng mL(-1) was 1.37 (95% CI, 1.13-1.66) for men and 0.96 (95% CI, 0.90-1.03) for women. The differences between genders were statistically significant (P for interaction = 0.006). Subgroup and sensitivity analyses generally confirmed the robustness of these findings. Furthermore, the increased risk in men appeared non-linear, with a tendency to plateau at high levels (P for non-linearity = 0.03). Little evidence of publication bias was found. Collectively, higher leptin levels were found to be associated with elevated risk of type 2 diabetes in men but not in women.
这项荟萃分析旨在评估循环瘦素水平与 2 型糖尿病风险之间的性别特异性差异。纳入了报道特定性别中瘦素水平与 2 型糖尿病风险之间关联的前瞻性研究，或报道性别特异性关联的研究。采用广义最小二乘法趋势估计评估剂量-反应关系，并采用随机效应模型计算汇总相对风险（RR）及其 95%置信区间（CI）。还进行了分层和敏感性分析，以探究潜在的异质性来源。总体而言，确定了 11 项前瞻性研究。对于男性，瘦素水平每增加 1-log ng/mL，RR 为 1.37（95%CI，1.13-1.66）；对于女性，RR 为 0.96（95%CI，0.90-1.03）。性别间的差异具有统计学意义（P 交互=0.006）。亚组和敏感性分析通常证实了这些发现的稳健性。此外，男性的风险增加似乎是非线性的，在高水平时趋于平稳（P 非线性=0.03）。几乎没有发现发表偏倚的证据。总的来说，较高的瘦素水平与男性 2 型糖尿病风险的增加相关，但与女性无关。
