Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, 430030, People's Republic of China.
Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, 430030, People's Republic of China.
Diabetologia. 2020 May;63(5):954-963. doi: 10.1007/s00125-020-05102-x. Epub 2020 Feb 7.
AIMS/HYPOTHESIS: There is evidence for a bidirectional association between type 2 diabetes and Alzheimer's disease. Plasma β-amyloid (Aβ) is a potential biomarker for Alzheimer's disease. We aimed to investigate the association of plasma Aβ40 and Aβ42 with risk of type 2 diabetes.
We performed a case-control study and a nested case-control study within a prospective cohort study. In the case-control study, we included 1063 newly diagnosed individuals with type 2 diabetes and 1063 control participants matched by age (±3 years) and sex. In the nested case-control study, we included 121 individuals with incident type 2 diabetes and 242 matched control individuals. Plasma Aβ40 and Aβ42 concentrations were simultaneously measured with electrochemiluminescence immunoassay. Conditional logistic regression was used to evaluate the association of plasma Aβ40 and Aβ42 concentrations with the likelihood of type 2 diabetes.
In the case-control study, the multivariable-adjusted ORs for type 2 diabetes, comparing the highest with the lowest quartile of plasma Aβ concentrations, were 1.97 (95% CI 1.46, 2.66) for plasma Aβ40 and 2.01 (95% CI 1.50, 2.69) for plasma Aβ42. Each 30 ng/l increment of plasma Aβ40 was associated with 28% (95% CI 15%, 43%) higher odds of type 2 diabetes, and each 5 ng/l increment of plasma Aβ42 was associated with 37% (95% CI 21%, 55%) higher odds of type 2 diabetes. Individuals in the highest tertile for both plasma Aβ40 and Aβ42 concentrations had 2.96-fold greater odds of type 2 diabetes compared with those in the lowest tertile for both plasma Aβ40 and Aβ42 concentrations. In the nested case-control study, the multivariable-adjusted ORs for type 2 diabetes for the highest vs the lowest quartile were 3.79 (95% CI 1.81, 7.94) for plasma Aβ40 and 2.88 (95% CI 1.44, 5.75) for plasma Aβ42. The multivariable-adjusted ORs for type 2 diabetes associated with each 30 ng/l increment in plasma Aβ40 and each 5 ng/l increment in plasma Aβ42 were 1.44 (95% CI 1.18, 1.74) and 1.47 (95% CI 1.15, 1.88), respectively.
CONCLUSIONS/INTERPRETATION: Our findings suggest positive associations of plasma Aβ40 and Aβ42 concentration with risk of type 2 diabetes. Further studies are warranted to elucidate the underlying mechanisms and explore the potential roles of plasma Aβ in linking type 2 diabetes and Alzheimer's disease.
目的/假设:有证据表明 2 型糖尿病和阿尔茨海默病之间存在双向关联。血浆β-淀粉样蛋白(Aβ)是阿尔茨海默病的潜在生物标志物。我们旨在研究血浆 Aβ40 和 Aβ42 与 2 型糖尿病风险的关系。
我们进行了病例对照研究和前瞻性队列研究中的嵌套病例对照研究。在病例对照研究中,我们纳入了 1063 名新诊断的 2 型糖尿病患者和 1063 名年龄(±3 岁)和性别匹配的对照组参与者。在嵌套病例对照研究中,我们纳入了 121 名新发 2 型糖尿病患者和 242 名匹配的对照组参与者。同时使用电化学发光免疫测定法测量血浆 Aβ40 和 Aβ42 浓度。条件逻辑回归用于评估血浆 Aβ40 和 Aβ42 浓度与 2 型糖尿病发生的可能性之间的关联。
在病例对照研究中,与血浆 Aβ 浓度最低四分位相比,血浆 Aβ40 和 Aβ42 浓度最高四分位的 2 型糖尿病多变量调整比值比(OR)分别为 1.97(95%CI 1.46,2.66)和 2.01(95%CI 1.50,2.69)。血浆 Aβ40 每增加 30ng/l,2 型糖尿病的几率就会增加 28%(95%CI 15%,43%),而血浆 Aβ42 每增加 5ng/l,2 型糖尿病的几率就会增加 37%(95%CI 21%,55%)。与血浆 Aβ40 和 Aβ42 浓度最低三分位的参与者相比,血浆 Aβ40 和 Aβ42 浓度最高三分位的参与者发生 2 型糖尿病的几率高 2.96 倍。在嵌套病例对照研究中,与血浆 Aβ40 和 Aβ42 浓度最低四分位相比,血浆 Aβ40 和 Aβ42 浓度最高四分位的 2 型糖尿病多变量调整比值比(OR)分别为 3.79(95%CI 1.81,7.94)和 2.88(95%CI 1.44,5.75)。血浆 Aβ40 每增加 30ng/l 和血浆 Aβ42 每增加 5ng/l,与 2 型糖尿病相关的多变量调整比值比(OR)分别为 1.44(95%CI 1.18, 1.74)和 1.47(95%CI 1.15, 1.88)。
结论/解释:我们的研究结果表明,血浆 Aβ40 和 Aβ42 浓度与 2 型糖尿病风险呈正相关。需要进一步的研究来阐明潜在的机制,并探讨血浆 Aβ 在将 2 型糖尿病与阿尔茨海默病联系起来的潜在作用。