高敏C反应蛋白与2型糖尿病风险：一项全国性队列研究及更新的荟萃分析。

High-sensitivity C-reactive protein and risk of type 2 diabetes: A nationwide cohort study and updated meta-analysis.

作者信息

Yang Xue, Tao Siyuan, Peng Jieru, Zhao Jian, Li Sheyu, Wu Nianwei, Wen Ying, Xue Qingping, Yang Chun-Xia, Pan Xiong-Fei

机构信息

Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Diabetes Metab Res Rev. 2021 Nov;37(8):e3446. doi: 10.1002/dmrr.3446. Epub 2021 Mar 29.

DOI:10.1002/dmrr.3446

PMID:33686799

Abstract

OBJECTIVE

To prospectively examine the association of high sensitivity C-reactive protein (hs-CRP) with incident type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese, and validate the association in an updated meta-analysis of prospective studies.

METHODS

We used data from the China Health and Retirement Longitudinal Study, started in 2011-2012 with follow ups in 2013-2014 and 2015-2016. Multivariable Cox proportional hazard regressions were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between hs-CRP level and incident T2DM. An updated meta-analysis was conducted to combine our estimates with those in previous prospective studies.

RESULTS

Included in the analyses were 7985 participants (mean age: 59.38 years; men: 46.73%). Higher hs-CRP was associated with increased risk of T2DM (multivariable-adjusted HR, 1.30; 95% CI: 1.03, 1.64 for comparing extreme quartiles). The association was stronger in participants with body mass index (BMI) of 24.0 kg/m or higher than those with a BMI lower than 24.0 kg/m (p for interaction = 0.038). In a meta-analysis of 28 cohorts, 2 case-cohort, and 6 nested case-control studies among 125,356 participants with 10,759 cases, the pooled relative risk for T2DM was 1.77 (95% CI: 1.60, 1.96) for the highest versus lowest level of hs-CRP.

CONCLUSIONS

Hs-CRP was associated with higher risk of T2DM in middle-aged and elderly Chinese, and this association was confirmed by an updated meta-analysis of prospective studies. Our findings highlight the role of elevated hs-CRP in the development of T2DM.

摘要

目的

前瞻性研究高敏C反应蛋白（hs-CRP）与中国中老年人群2型糖尿病（T2DM）发病之间的关联，并在前瞻性研究的更新荟萃分析中验证该关联。

方法

我们使用了中国健康与养老追踪调查（China Health and Retirement Longitudinal Study）的数据，该调查于2011 - 2012年启动，并在2013 - 2014年和2015 - 2016年进行了随访。采用多变量Cox比例风险回归来估计hs-CRP水平与T2DM发病之间关联的风险比（HRs）和95%置信区间（CIs）。进行了一项更新的荟萃分析，将我们的估计值与先前前瞻性研究中的估计值相结合。

结果

纳入分析的有7985名参与者（平均年龄：59.38岁；男性：46.73%）。较高的hs-CRP与T2DM风险增加相关（多变量调整后的HR为1.30；比较极端四分位数时的95% CI：1.03，1.64）。在体重指数（BMI）≥24.0 kg/m²的参与者中，这种关联比BMI<24.0 kg/m²的参与者更强（交互作用p = 0.038）。在一项针对125356名参与者（其中10759例病例）的28个队列、2个病例队列和6个巢式病例对照研究的荟萃分析中，hs-CRP最高水平与最低水平相比，T2DM的合并相对风险为1.77（95% CI：1.60，1.96）。