Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Internal Medicine, Chungbuk National University Hospital and Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
J Clin Endocrinol Metab. 2020 Mar 1;105(3):e381-9. doi: 10.1210/clinem/dgz171.
The long-term association between multiple cytokines and progression to diabetes is still uncertain.
To identify which cytokines could predict progression to prediabetes and type 2 diabetes over 10 years.
The study included 912 participants aged 40 to 69 years at baseline from the Ansung cohort, part of the Korea Genome Epidemiology Study. At baseline, a 75-g oral glucose tolerance test and 8 cytokines were measured: plasminogen activator inhibitor 1 (PAI-1), resistin, interleukin 6, leptin, monocyte chemoattractant protein 1, tumor necrosis factor alpha, retinol binding protein 4 (RBP4), and adiponectin. People with normal glucose tolerance (NGT, n = 241) and prediabetes (n = 330) were followed-up biennially for 10 years. Multinomial logistic regression analysis was used to evaluate the predictability of cytokines on the new-onset prediabetes and type 2 diabetes.
At 10 years, 38 (15.8%) and 82 (34.0%) of those with NGT had converted to prediabetes and type 2 diabetes, respectively. Of those with prediabetes, 228 (69.1%) had converted to type 2 diabetes. In people with NGT or prediabetes at baseline, the highest tertile of RBP4 was associated with a 5.48-fold and 2.43-fold higher risk of progression to type 2 diabetes, respectively. The odds for converting from NGT to prediabetes in the highest tertile of PAI-1 and the lowest tertile of adiponectin were 3.23 and 3.37, respectively. In people with prediabetes at baseline, those in the highest tertile of resistin were 2.94 time more likely to develop type 2 diabetes (all P < 0.05).
In this 10-year prospective study, NGT with higher serum RBP4 and PAI-1, and with lower adiponectin were associated with new-onset prediabetes and type 2 diabetes.
多种细胞因子与向糖尿病进展之间的长期关联仍不确定。
确定哪些细胞因子可以预测 10 年内向糖尿病前期和 2 型糖尿病的进展。
该研究纳入了基线时年龄在 40 至 69 岁的来自 Ansung 队列的 912 名参与者，该队列是韩国基因组流行病学研究的一部分。基线时进行了 75g 口服葡萄糖耐量试验和 8 种细胞因子的检测：纤溶酶原激活物抑制剂 1（PAI-1）、抵抗素、白细胞介素 6、瘦素、单核细胞趋化蛋白 1、肿瘤坏死因子-α、视黄醇结合蛋白 4（RBP4）和脂联素。将糖耐量正常（NGT，n=241）和糖尿病前期（n=330）的人群进行为期 10 年的每两年一次的随访。使用多项逻辑回归分析评估细胞因子对新发糖尿病前期和 2 型糖尿病的预测能力。
在 10 年内，有 38 例（15.8%）NGT 患者和 82 例（34.0%）患者进展为糖尿病前期和 2 型糖尿病。在糖尿病前期患者中，有 228 例（69.1%）进展为 2 型糖尿病。在基线时患有 NGT 或糖尿病前期的患者中，RBP4 的最高三分位数与进展为 2 型糖尿病的风险分别增加 5.48 倍和 2.43 倍相关。PAI-1 最高三分位数和脂联素最低三分位数与从 NGT 向糖尿病前期进展的比值比分别为 3.23 和 3.37。在基线时患有糖尿病前期的患者中，抵抗素最高三分位数的患者发展为 2 型糖尿病的风险增加 2.94 倍（均 P<0.05）。
在这项为期 10 年的前瞻性研究中，血清 RBP4 和 PAI-1 水平较高、脂联素水平较低的 NGT 与新发糖尿病前期和 2 型糖尿病相关。
