Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Diabetes Care. 2017 Mar;40(3):346-351. doi: 10.2337/dc16-1295. Epub 2016 Dec 28.
We aimed to investigate the role of serum levels of various apolipoproteins on the risk for type 2 diabetes (T2D).
We used data from 971 individuals from the prospective population-based Rotterdam Study. We studied the association of HDL cholesterol (HDL-C), apoA1, apoCIII, apoD, and apoE as well as the ratios of apolipoproteins with apoA1 with the risk of T2D. All apolipoproteins, ratios, and HDL-C levels were naturally log-transformed to reach normal distribution. First, their cross-sectional associations with fasting glucose and insulin were investigated by using linear regression. Second, Cox proportional hazard models were used to examine whether apolipoproteins predict the risk for T2D among individuals free of diabetes at baseline. We also studied the apolipoproteins jointly by calculating the apolipoproteinic score from the first step and then performing Cox regression with it.
During a median follow-up of 13.5 years, diabetes developed in 110 individuals. After adjustment for age, sex, BMI, parental history of diabetes, hypertension, alcohol use, smoking, prevalent cardiovascular disease, and serum lipid-reducing agents, HDL-C (per 1 SD naturally log-transformed hazard ratio 0.74 [95% CI 0.57, 0.97], apoCIII (1.65 [1.42, 1.91]), apoE (1.36 [1.18, 1.55]), apoCIII-to-apoA1 ratio (1.72 [1.51, 1.95]), apoE-to-apoA1 ratio (1.28 [1.13, 1.45]), and apolipoproteinic score (1.60 [1.39, 1.83]) remained significant. Only apoCIII (1.42 [1.03, 1.96]) and apoCIII-to-apoA1 ratio (1.56 [1.04, 2.36]) survived the adjustment for triglycerides in the last model.
Serum apoCIII levels as well as apoCIII-to-apoA1 ratio are associated with incident T2D. They are associated independent of known risk factors and stronger than HDL-C levels.
我们旨在探究各种载脂蛋白在 2 型糖尿病（T2D）风险中的作用。
我们使用来自前瞻性人群为基础的鹿特丹研究的 971 名个体的数据。我们研究了高密度脂蛋白胆固醇（HDL-C）、载脂蛋白 A1（apoA1）、载脂蛋白 CIII（apoCIII）、载脂蛋白 D（apoD）和载脂蛋白 E（apoE）以及载脂蛋白 A1 与载脂蛋白比值与 T2D 风险之间的关系。所有载脂蛋白、比值和 HDL-C 水平均经自然对数转换以达到正态分布。首先，我们使用线性回归研究它们与空腹血糖和胰岛素的横断面关系。其次，我们使用 Cox 比例风险模型来检验在基线时无糖尿病的个体中载脂蛋白是否预测 T2D 风险。我们还通过从第一步计算载脂蛋白指数并使用 Cox 回归来联合研究载脂蛋白。
在中位随访 13.5 年期间，110 名个体发生了糖尿病。在校正年龄、性别、BMI、父母糖尿病史、高血压、饮酒、吸烟、现患心血管疾病和血清降脂药物后，HDL-C（每 1 个自然对数转换的标准差的危害比为 0.74 [95%CI 0.57，0.97]）、apoCIII（1.65 [1.42，1.91]）、apoE（1.36 [1.18，1.55]）、apoCIII/apoA1 比值（1.72 [1.51，1.95]）、apoE/apoA1 比值（1.28 [1.13，1.45]）和载脂蛋白指数（1.60 [1.39，1.83]）仍然显著。只有 apoCIII（1.42 [1.03，1.96]）和 apoCIII/apoA1 比值（1.56 [1.04，2.36]）在最后一个模型中经过甘油三酯调整后仍然显著。
血清 apoCIII 水平以及 apoCIII/apoA1 比值与 T2D 的发生有关。它们与已知的危险因素有关，并且比 HDL-C 水平更强。
