Tilves Curtis M, Zmuda Joseph M, Kuipers Allison L, Nestlerode Cara S, Evans Rhobert W, Bunker Clareann H, Patrick Alan L, Miljkovic Iva
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Diabetes Care. 2016 Mar;39(3):385-91. doi: 10.2337/dc15-1777. Epub 2015 Dec 30.
Cross-sectional studies suggest that lipopolysaccharide-binding protein (LBP) may be associated with obesity and metabolic disorders. However, prospective studies examining LBP are lacking. This prospective study investigated the association between LBP and metabolic abnormalities in 580 African ancestry men (mean age, 59.1 ± 10.5 years).
We measured fasting serum LBP at baseline. Changes in adiposity and glucose homeostasis as well as case subjects with new type 2 diabetes and impaired fasting glucose (IFG) were assessed at a follow-up visit ~6 years later. Baseline LBP values were tested across quartiles for linear trend with metabolic measures. Multivariable logistic regression was used to determine the odds of new cases of IFG or diabetes per 1-SD greater baseline LBP.
LBP was significantly associated with baseline BMI, waist circumference, whole-body and trunk fat, skeletal muscle density, fasting serum insulin, and HOMA-insulin resistance (IR) (all P < 0.01). Greater baseline LBP was significantly associated with longitudinal increases in the percentage of trunk fat (P = 0.025) and HOMA-IR (P = 0.034), but only borderline so with a decrease in skeletal muscle density (P = 0.057). In men with normal glucose, baseline LBP was associated with increased odds of having IFG at follow-up after adjustment for age, baseline trunk fat, and lifestyle factors (odds ratio per 1-SD LBP: 1.51; 95% CI 1.02-2.21). This association was attenuated after additional adjustment for change in trunk fat (P = 0.067).
LBP may be a marker of prediabetes. Some of this association appears to be mediated through increased central and ectopic skeletal muscle adiposity.
横断面研究表明,脂多糖结合蛋白(LBP)可能与肥胖和代谢紊乱有关。然而,缺乏对LBP的前瞻性研究。这项前瞻性研究调查了580名非洲裔男性(平均年龄59.1±10.5岁)中LBP与代谢异常之间的关联。
我们在基线时测量空腹血清LBP。在约6年后的随访中评估肥胖和葡萄糖稳态的变化以及新发2型糖尿病和空腹血糖受损(IFG)的病例。对基线LBP值在四分位数间进行代谢指标的线性趋势检验。使用多变量逻辑回归来确定每增加1个标准差基线LBP时IFG或糖尿病新发病例的几率。
LBP与基线BMI、腰围、全身和躯干脂肪、骨骼肌密度、空腹血清胰岛素和HOMA胰岛素抵抗(IR)显著相关(均P<0.01)。更高的基线LBP与躯干脂肪百分比(P = 0.025)和HOMA-IR(P = 0.034)的纵向增加显著相关,但与骨骼肌密度降低仅呈临界相关(P = 0.057)。在血糖正常的男性中,调整年龄、基线躯干脂肪和生活方式因素后,基线LBP与随访时发生IFG的几率增加相关(每1个标准差LBP的比值比:1.51;95%CI 1.02-2.21)。在进一步调整躯干脂肪变化后,这种关联减弱(P = 0.067)。
LBP可能是糖尿病前期的一个标志物。这种关联部分似乎是通过中心性和异位骨骼肌脂肪增加介导的。