Department of Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
Arch Med Res. 2017 Aug;48(6):535-545. doi: 10.1016/j.arcmed.2017.11.010. Epub 2017 Dec 6.
While inflammation is associated with obesity and insulin resistance, their inter-relationships in the development of type 2 diabetes or hypertension are not clear.
To evaluate inflammatory markers in prediction of type 2 diabetes and hypertension.
The study population of this retrospective cohort study consisted of individuals who participated in a comprehensive health screening program with measurement of white blood cell count and C-reactive protein from 2002-2010 (N = 96,606) in nondiabetic and normotensive Koreans. Median follow up time were 3.7 years for incident type 2 diabetes and 3.3 years for hypertension. Multivariate Cox proportional hazards models were performed to assess risk for type 2 diabetes or hypertension by white blood cell or C-reactive protein quartiles with adjustment of various possible confounding factors including insulin resistance.
During the follow-up period, 1448 (1.5%) developed type 2 diabetes and 10,405 (10.8%) developed hypertension. Among men, comparison of adjusted hazard ratios (HR) for incident type 2 diabetes in the highest versus lowest white blood cell or C-reactive protein quartiles were 1.48 [95% confidence interval (CI), 1.20-1.83] and 1.30 (95% CI, 1.07-1.57), respectively. Among women, white blood cell but not C-reactive protein was significantly associated with type 2 diabetes [HR 1.79 (95% CI 1.24-2.57)]. White blood cell and C-reactive protein quartiles were also modestly associated with incident hypertension in both sexes.
Although white blood cell and C-reactive protein are associated with adiposity and insulin resistance, these inflammatory markers also independently predict type 2 diabetes and/or hypertension.
炎症与肥胖和胰岛素抵抗有关，但它们在 2 型糖尿病或高血压发展中的相互关系尚不清楚。
评估炎症标志物对 2 型糖尿病和高血压的预测作用。
本回顾性队列研究的研究人群包括 2002-2010 年参加全面健康筛查计划的非糖尿病和血压正常的韩国人，该计划测量了白细胞计数和 C 反应蛋白（N=96606）。中位随访时间为新发 2 型糖尿病 3.7 年，高血压 3.3 年。使用多变量 Cox 比例风险模型，根据白细胞或 C 反应蛋白四分位值，调整各种可能的混杂因素（包括胰岛素抵抗），评估 2 型糖尿病或高血压的风险。
在随访期间，1448 人（1.5%）发生 2 型糖尿病，10405 人（10.8%）发生高血压。在男性中，最高与最低白细胞或 C 反应蛋白四分位值相比，新发 2 型糖尿病的校正风险比（HR）分别为 1.48（95%置信区间[CI]，1.20-1.83）和 1.30（95% CI，1.07-1.57）。在女性中，白细胞与 2 型糖尿病显著相关（HR 1.79[95% CI 1.24-2.57]），而 C 反应蛋白则无显著相关性。白细胞和 C 反应蛋白四分位值也与两性高血压的发生有一定的相关性。
尽管白细胞和 C 反应蛋白与肥胖和胰岛素抵抗有关，但这些炎症标志物也独立预测 2 型糖尿病和/或高血压。
