心血管健康研究中老年人IGF-I与IGFBP-3和新发糖尿病之间的关联
The Association Between IGF-I and IGFBP-3 and Incident Diabetes in an Older Population of Men and Women in the Cardiovascular Health Study.
作者信息
Aneke-Nash Chino S, Xue Xiaonan, Qi Qibin, Biggs Mary L, Cappola Anne, Kuller Lewis, Pollak Michael, Psaty Bruce M, Siscovick David, Mukamal Kenneth, Strickler Howard D, Kaplan Robert C
机构信息
Department of Epidemiology and Population Health, Albert Einstein College of Medicine.
Department of Biostatistics, University of Washington.
出版信息
J Clin Endocrinol Metab. 2017 Dec 1;102(12):4541-4547. doi: 10.1210/jc.2017-01273.
CONTEXT
Insulin-like growth factor-I (IGF-I) has structural and functional similarities to insulin and may play a role in glucose homeostasis, along with insulin-like growth factor binding protein-3 (IGFBP-3), which binds the majority of circulating IGF-I.
OBJECTIVE
To assess whether IGF-I and IGFBP-3 are associated with a higher risk of incident diabetes in older adults.
DESIGN
Participants in the Cardiovascular Health Study (n = 3133), a cohort of adults aged ≥65 years, were observed for 16 years (n = 3133) for the development of incident diabetes. Statistical models were fit separately for men and women because of interactions with sex (P interaction: IGF-I, 0.02; IGFBP-3, 0.009) and were adjusted for relevant covariates.
SETTING
General community.
PARTICIPANTS
Older adults who were nondiabetic at baseline and who did not develop diabetes within the first year of follow-up.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURE
Incident diabetes as measured by fasting plasma glucose (FPG) ≥126 mg/dL, non-FPG ≥200 mg/dL, use of pharmacological treatment of diabetes, or existence of two or more inpatient or three or more outpatient or (at least one inpatient and at least one outpatient) Centers for Medicare & Medicaid Services claims with the diagnostic International Classification of Diseases, Ninth Revision, Clinical Modification code of 250.xx.
RESULTS
In women, higher IGFBP-3 (hazard ratio tertile 3 vs tertile 1 = 2.30; 95% confidence interval, 1.55 to 3.40; P trend < 0.0001) was significantly associated with incident diabetes. Total IGF-I was not significantly associated with incident diabetes. In men, neither IGF-I nor IGFBP-3 was significantly associated with incident diabetes.
CONCLUSIONS
We confirmed a previously reported association between circulating IGFBP-3 and diabetes risk in the older adult population, establishing that this association is present among women but could not be shown to be associated in men.
背景
胰岛素样生长因子-I（IGF-I）在结构和功能上与胰岛素相似，可能在葡萄糖稳态中发挥作用，同时胰岛素样生长因子结合蛋白-3（IGFBP-3）能结合大部分循环中的IGF-I。
目的
评估IGF-I和IGFBP-3是否与老年人发生糖尿病的较高风险相关。
设计
心血管健康研究中的参与者（n = 3133），这是一个年龄≥65岁的成年人队列，对其进行了16年的观察（n = 3133）以观察糖尿病的发生情况。由于存在性别交互作用（交互作用P值：IGF-I为0.02；IGFBP-3为0.009），因此分别对男性和女性拟合统计模型，并对相关协变量进行了调整。
地点
普通社区。
参与者
基线时非糖尿病且在随访的第一年内未发生糖尿病的老年人。
干预措施
不适用。
主要结局指标
通过空腹血糖（FPG）≥126 mg/dL、非FPG≥200 mg/dL、使用糖尿病药物治疗或存在两条或更多条住院或三条或更多条门诊或（至少一条住院和至少一条门诊）医疗保险和医疗补助服务中心的诊断为国际疾病分类第九版临床修订版代码250.xx的索赔来衡量的新发糖尿病。
结果
在女性中，较高的IGFBP-3（三分位数3与三分位数1相比的风险比 = 2.30；95%置信区间，1.55至3.40；P趋势 < 0.0001）与新发糖尿病显著相关。总IGF-I与新发糖尿病无显著相关性。在男性中，IGF-I和IGFBP-3均与新发糖尿病无显著相关性。
结论
我们证实了先前报道的确立循环IGFBP-3与老年人群糖尿病风险之间的关联，即这种关联在女性中存在，但在男性中未显示出相关性。
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