Division of Intramural Research, National Institute on Minority Health and Health Disparities, 9000 Rockville Pike, Building 3, Floor 5, Room 5W13, Bethesda, MD 20892, USA.
LEAD Center, Colorado School of Public Health, Anschutz Medical Campus, 12474 E 19th Avenue, Rm. 112, Campus Box F426, Aurora, Colorado 80045, USA.
J Diabetes Res. 2020 Aug 15;2020:2767393. doi: 10.1155/2020/2767393. eCollection 2020.
Assess prospective relationships between obesity and inflammation on the incidence of type 2 diabetes mellitus (T2DM).
A cohort of nondiabetic respondents from the Coronary Artery Risk Development in Young Adults (CARDIA) study was followed from 2005-2006 (wave 7) to 2010-2011 (wave 8). Diabetes status was determined in wave 8 based on self-report, blood glucose level, and anti-hyperglycemic medication use in conjunction with a homeostatic model assessment-based classification for distinguishing diabetes subtype. We performed a series of multivariable logistic regression analyses to assess the relative influence of obesity (waist circumference) and individual inflammatory biomarkers (i.e., C-reactive protein, fibrinogen, and sex-specific serum uric acid and gamma-glutamyltransferase) on the odds of developing incident T2DM between waves 7 and 8.
Among 2784 nondiabetic CARDIA respondents, 146 (5.2%) new cases of T2DM were identified between waves. Having a high waist circumference (AOR = 6.15; 95%CI = 4.14, 9.14) and being Black (vs. White) (AOR = 1.60; 95%CI = 1.05, 2.44) were associated with T2DM. Adjusting for inflammation biomarkers attenuated the effects of waist circumference and race with T2DM. Clinically elevated CRP (AOR = 1.83; 95%CI = 1.18, 2.82) and uric acid (AOR = 2.57; 95%CI = 1.70, 3.89) predicted T2DM among all respondents. However, stratification by race showed greater attenuation of the effects of waist circumference on T2DM in Whites than in Blacks when inflammation biomarkers were accounted for in the model.
Targeted control of systemic inflammation may reduce the risk of developing T2DM, especially among Blacks, and could help address Black-White disparities in diabetes care and outcomes.
评估肥胖与炎症对 2 型糖尿病（T2DM）发病的潜在关系。
从冠状动脉风险发展在年轻人（CARDIA）研究的非糖尿病受访者中招募队列，从 2005-2006 年（第 7 波）随访至 2010-2011 年（第 8 波）。第 8 波时根据自我报告、血糖水平以及联合使用基于稳态模型评估的分类来区分糖尿病亚型的抗高血糖药物使用情况来确定糖尿病状态。我们进行了一系列多变量逻辑回归分析，以评估肥胖（腰围）和个体炎症生物标志物（即 C 反应蛋白、纤维蛋白原以及性别特异性血清尿酸和γ-谷氨酰转移酶）在第 7 波和第 8 波之间对发生 T2DM 的几率的相对影响。
在 2784 名非糖尿病 CARDIA 受访者中，在波之间发现了 146 例（5.2%）新的 T2DM 病例。高腰围（比值比[OR] = 6.15；95%置信区间[CI] = 4.14，9.14）和黑人（与白人相比）（OR = 1.60；95%CI = 1.05，2.44）与 T2DM 相关。调整炎症生物标志物减弱了腰围和种族与 T2DM 的关联。临床升高的 CRP（OR = 1.83；95%CI = 1.18，2.82）和尿酸（OR = 2.57；95%CI = 1.70，3.89）预测了所有受访者的 T2DM。然而，按种族分层显示，当模型中考虑炎症生物标志物时，腰围对 T2DM 的影响在白人中比在黑人中减弱更多。
靶向控制全身炎症可能会降低发生 T2DM 的风险，尤其是在黑人中，并有助于解决糖尿病护理和结果方面的黑人和白人之间的差异。
