Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
Department of Medicine, University of Mississippi Medical Center, Jackson, USA.
Diabet Med. 2021 May;38(5):e14465. doi: 10.1111/dme.14465. Epub 2020 Dec 25.
To evaluate the association between plasma biomarkers including leptin, adiponectin, adiponectin-to-leptin ratio and high-sensitivity C-reactive protein (hsCRP) with risk of glycaemic progression and incident dysglycaemia (pre-diabetes or diabetes) in a community-based sample of African American (AAs).
We analysed data from 3223 participants without type 2 diabetes at baseline (2000-2004) who attended ≥1 follow-up visit. Poisson regression was used to generate risk ratios (RRs) for glycaemic progression and incident dysglycaemia.
Over a median of 7 years, 46.4% developed glycaemic progression (n=1495). After adjusting for demographic and lifestyle variables, the RRs (95% CI) for glycaemic progression comparing highest (Q4) to lowest (Q1) quartiles were 1.30 (1.10-1.54), 0.74 (0.65-0.84), 0.70 (0.62-0.80) and 1.22 (1.07-1.38) for leptin, adiponectin, adiponectin-leptin ratio and hsCRP, respectively. Upon additional adjustment for BMI, the corresponding RRs (95% CIs) were 1.15 (0.94-1.42), 0.76 (0.67-0.86), 0.72 (0.62-0.84) and 1.14 (0.99-1.31) respectively. Among participants with normal glycaemia, the RRs (95% CIs) for incident pre-diabetes in Q4 vs Q1 were 1.37 (1.13-1.67), 0.73 (0.63-0.85), 0.70 (0.59-0.82) and 1.28 (1.10-1.48) for leptin, adiponectin, adiponectin-leptin ratio and hsCRP, respectively; equivalent RRs for incident diabetes were 5.15 (2.63-10.10), 0.36 (0.20-0.68), 0.21 (0.12-0.38) and 3.04 (1.70-5.44), respectively.
In this large community-based cohort of AAs, our results suggest that high plasma leptin and hsCRP, as well as low adiponectin and adiponectin-to-leptin ratio, are associated with higher risks of glycaemic progression. The findings point to the potential utility of these biomarkers in predicting and preventing glycaemic progression in this high-risk population.
评估包括瘦素、脂联素、脂联素与瘦素比值和高敏 C 反应蛋白(hsCRP)在内的血浆生物标志物与非裔美国人(AA)社区样本中血糖进展和新发糖代谢异常(糖尿病前期或糖尿病)风险之间的关联。
我们分析了基线时(2000-2004 年)无 2 型糖尿病且至少参加了 1 次随访的 3223 名参与者的数据。使用泊松回归生成血糖进展和新发糖代谢异常的风险比(RR)。
中位时间为 7 年,46.4%的参与者发生了血糖进展(n=1495)。在调整人口统计学和生活方式变量后,与最低(Q1)四分位相比,最高(Q4)四分位的血糖进展 RR(95%CI)分别为 1.30(1.10-1.54)、0.74(0.65-0.84)、0.70(0.62-0.80)和 1.22(1.07-1.38)。对于瘦素、脂联素、脂联素与瘦素比值和 hsCRP,分别为 1.15(0.94-1.42)、0.76(0.67-0.86)、0.72(0.62-0.84)和 1.14(0.99-1.31)。在血糖正常的参与者中,Q4 与 Q1 相比,新发糖尿病前期的 RR(95%CI)分别为 1.37(1.13-1.67)、0.73(0.63-0.85)、0.70(0.59-0.82)和 1.28(1.10-1.48)。对于瘦素、脂联素、脂联素与瘦素比值和 hsCRP,新发糖尿病的 RR(95%CI)分别为 5.15(2.63-10.10)、0.36(0.20-0.68)、0.21(0.12-0.38)和 3.04(1.70-5.44)。
在这项大型非裔美国人社区队列研究中,我们的结果表明,血浆中瘦素和 hsCRP 水平升高,以及脂联素和脂联素与瘦素比值降低,与血糖进展风险增加相关。这些发现表明,这些生物标志物在预测和预防该高危人群的血糖进展方面具有潜在的应用价值。