Medical Research Council Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Diabetologia. 2021 Apr;64(4):845-849. doi: 10.1007/s00125-020-05377-0. Epub 2021 Jan 26.
AIMS/HYPOTHESIS: Our aim was to investigate the relationship between average blood glucose levels and incident CHD in individuals without diabetes mellitus.
To investigate average blood glucose levels, we studied HbA as predicted by 40 variants previously shown to be associated with both type 2 diabetes and HbA. Linear and non-linear Mendelian randomisation analyses were performed to investigate associations with incident CHD risk in 324,830 European ancestry individuals from the UK Biobank without diabetes mellitus.
Every one mmol/mol increase in genetically proxied HbA was associated with an 11% higher CHD risk (HR 1.11, 95% CI 1.05, 1.18). The dose-response curve increased at all levels of HbA, and there was no evidence favouring a non-linear relationship over a linear one.
CONCLUSIONS/INTERPRETATIONS: In individuals without diabetes mellitus, lowering average blood glucose levels may reduce CHD risk in a dose-dependent way.
目的/假设:我们的目的是研究无糖尿病个体的平均血糖水平与冠心病(CHD)事件之间的关系。
为了研究平均血糖水平,我们研究了 40 种先前显示与 2 型糖尿病和 HbA 均相关的变异体所预测的 HbA。在英国生物库中,我们对没有糖尿病的 324830 名欧洲血统个体进行了线性和非线性孟德尔随机化分析,以调查与冠心病风险事件的关联。
遗传上接近的 HbA 每增加 1mmol/mol,冠心病风险就会升高 11%(HR 1.11,95%CI 1.05,1.18)。在 HbA 的所有水平上,剂量-反应曲线都在增加,没有证据表明非线性关系优于线性关系。
结论/解释:在没有糖尿病的个体中,降低平均血糖水平可能会以剂量依赖的方式降低冠心病风险。