Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
Department of Endocrinology, Dongguan People's Hospital, No. 3 South, Xinguyongwan Road, Wanjiang District, Dongguan, 523059, People's Republic of China.
Endocrine. 2021 May;72(2):423-436. doi: 10.1007/s12020-021-02632-1. Epub 2021 Mar 12.
We elucidate the effect of Growth differentiation factor-15(GDF-15)/adiponectin ratio in improving the assessment value for odds of type 2 diabetes.
Cross-sectional design. A total of 405 participants (135 patients with newly diagnosed type 2 diabetes, 135 age- and sex-matched participants with prediabetes, and 135 healthy controls) were collected from Guangzhou and Dongguan, China. The serum GDF-15 and adiponectin levels were measured by ELISA and latex-enhanced immunoturbidimetry. Logistic regression analysis and restricted cubic splines were used to evaluate the associations between diabetes and the indicators.
The low level of adiponectin and high GDF-15/adiponectin ratio were significantly associated with increased odds of type 2 diabetes, but not for GDF-15. Three clusters were identified based on the K-means clustering analysis. Compared to the lowest quartiles of adiponectin, the OR and 95% CI of the highest adiponectin with type 2 diabetes was 0.24 (0.07-0.74, p trend = 0.004) after adjusting for sex, age, BMI, and DBP only in cluster 1. After adjusting for confounding factors, subjects with the highest GDF-15/adiponectin ratio quartiles had 3.9 times (OR = 3.85, 95% CI = 0.76-24.25) and 3.8 times (OR = 3.80, 95% CI = 1.02-14.68) higher odds of type 2 diabetes in cluster 2 and cluster 3, respectively. The association between the GDF-15/adiponectin ratio and type 2 diabetes was attenuated, but still remarkable (OR = 3.18, 95% CI = 1.11-10.18), in cluster 1.
Higher GDF-15/adiponectin ratio is independently associated with increased odds of type 2 diabetes for all study populations, suggesting that the GDF-15/adiponectin ratio may be a better indicator of type 2 diabetes.
我们阐明了生长分化因子 15（GDF-15）/脂联素比值在提高 2 型糖尿病患病几率评估值方面的作用。
采用横断面设计。共收集了 405 名参与者（135 名新诊断为 2 型糖尿病患者、135 名年龄和性别匹配的糖尿病前期患者和 135 名健康对照者），来自中国广州和东莞。采用酶联免疫吸附法和乳胶增强免疫比浊法测定血清 GDF-15 和脂联素水平。采用 logistic 回归分析和限制立方样条分析评估糖尿病与各指标之间的关系。
低水平的脂联素和高水平的 GDF-15/脂联素比值与 2 型糖尿病患病几率的增加显著相关，但 GDF-15 则不然。基于 K-均值聚类分析，确定了 3 个聚类。与脂联素最低四分位数相比，在仅调整性别、年龄、BMI 和 DBP 后，聚类 1 中脂联素最高四分位数的 2 型糖尿病 OR 和 95%CI 为 0.24（0.07-0.74，p趋势=0.004）。在调整混杂因素后，GDF-15/脂联素比值最高四分位数的受试者在聚类 2 和聚类 3 中患 2 型糖尿病的几率分别高出 3.9 倍（OR=3.85，95%CI=0.76-24.25）和 3.8 倍（OR=3.80，95%CI=1.02-14.68）。在聚类 1 中，GDF-15/脂联素比值与 2 型糖尿病之间的关联虽然减弱，但仍具有显著意义（OR=3.18，95%CI=1.11-10.18）。
对于所有研究人群，较高的 GDF-15/脂联素比值与 2 型糖尿病患病几率的增加独立相关，提示 GDF-15/脂联素比值可能是 2 型糖尿病的一个更好的指标。
