Shodja Mary Michelle, Knutsen Raymond, Cao Jeffrey, Oda Keiji, Beeson Lawrence E, Fraser Gary E, Knutsen Synnove
Center for Nutrition, Healthy Lifestyle and Disease Prevention Faculty, Loma Linda, California, United State.
School of Medicine Loma Linda University, California, United State.
Jacobs J Diabetes Endocrinol. 2017 Jul;8(2):9-16. doi: 10.5897/JDE2017.0110. Epub 2017 Jul 31.
It is well established that diabetic patients with poor glycemic control have increased susceptibility to infections, but glucose levels have not been directly associated with this increase. The assessment of the effects of glycosylated hemoglobin (A c) on the body's ability to fight infections may be useful directly in establishing a link between elevated blood sugar and the risk of infections. A total of 127 subjects in Heart Pilot Study (HPS), sub-study of the Adventist Health Study 2 (AHS-2) completed a lifestyle, medical and food frequency questionnaire (FFQ) at baseline between 2013 and 2014. The A c and phagocytic index (PI) were measured in the same blood sample and their associations were assessed using linear regression. Mean blood glucose (MBG) was estimated based on A c levels using a standard formula. Three levels of MBG were used to compare prediabetic and diabetic ranges to the normal range. The PI is the average number of bacteria in the cytoplasm of 50 neutrophils, manually counted under a light microscope after the whole blood was briefly exposed to a standard dose of bacteria and stained. In multivariable analysis, we found that MBG in the prediabetic (117 to137 mg/dL) and diabetic (>137 mg/dL) ranges were associated with 12.9% (β= -0.129, 95% Cl: -0.30, 0.05) and 20.4% decrease in PI (β= -0.204, 95% Cl: -0.592, 0.184) compared to that, observed among those with normal MBG ( for trend=0.119). Elevated MBG levels contribute a decrease in the PI among those in the prediabetic and diabetic range compared to the normal range. Although our findings were not quite statistically significant due to low power which are clinically relevant in line with observations of an increased infections among diabetics. Further research on larger populations is needed.
众所周知，血糖控制不佳的糖尿病患者更容易感染，但血糖水平与感染风险增加并无直接关联。评估糖化血红蛋白（A c）对人体抗感染能力的影响，可能有助于直接建立高血糖与感染风险之间的联系。基督复临安息日会健康研究2（AHS - 2）的心脏先导研究（HPS）中的127名受试者，在2013年至2014年基线时完成了生活方式、医疗和食物频率问卷（FFQ）。在同一血样中测量A c和吞噬指数（PI），并使用线性回归评估它们之间的关联。根据A c水平，使用标准公式估算平均血糖（MBG）。采用三个MBG水平，将糖尿病前期和糖尿病范围与正常范围进行比较。PI是在全血短暂暴露于标准剂量细菌并染色后，在光学显微镜下人工计数的50个中性粒细胞细胞质内细菌的平均数。在多变量分析中，我们发现糖尿病前期（117至137 mg/dL）和糖尿病（>137 mg/dL）范围内的MBG与PI分别降低12.9%（β = -0.129，95% CI：-0.30，0.05）和20.4%（β = -0.204，95% CI：-0.592，0.184），与正常MBG者相比（趋势P = 0.119）。与正常范围相比，糖尿病前期和糖尿病范围内的MBG升高导致PI降低。尽管由于检验效能低，我们的研究结果在统计学上不太显著，但在临床上与糖尿病患者感染增加的观察结果相关。需要对更大规模人群进行进一步研究。
