Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK.
Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
J Endocrinol Invest. 2021 Nov;44(11):2417-2426. doi: 10.1007/s40618-021-01550-3. Epub 2021 Mar 17.
To determine the utility of estimated glucose disposal rate (eGDR) as a candidate biomarker for thrombotic biomarkers in patients with type 1 diabetes (T1D).
We reanalysed baseline pretreatment data in a subset of patients with T1D from two previous RCTs, consisting of a panel of thrombotic markers, including fibrinogen, tissue factor (TF) activity, and plasminogen-activator inhibitor (PAI)-1, and TNFα, and clinical factors (age, T1D duration, HbA1c, insulin requirements, BMI, blood pressure, and eGDR). We employed univariate linear regression models to investigate associations between clinical parameters and eGDR with thrombotic biomarkers.
Thirty-two patients were included [mean ± SD age 31 ± 7 years, HbA1c of 58 ± 9 mmol/mol (7.5 ± 0.8%), eGDR 7.73 ± 2.61]. eGDR negatively associated with fibrinogen (P < 0.001), PAI-1 concentrations (P = 0.005), and TF activity (P = 0.020), but not TNFα levels (P = 0.881). We identified 2 clusters of patients displaying significantly different characteristics; 56% (n = 18) were categorised as 'higher-risk', eliciting significantly higher fibrinogen (+ 1514 ± 594 μg/mL; P < 0.001), TF activity (+ 59.23 ± 9.42 pmol/mL; P < 0.001), and PAI-1 (+ 8.48 ± 1.58 pmol/dL; P < 0.001), HbA1c concentrations (+ 14.20 ± 1.04 mmol/mol; P < 0.001), age (+ 7 ± 3 years; P < 0.001), duration of diabetes (15 ± 2 years; P < 0.001), BMI (+ 7.66 ± 2.61 kg/m; P < 0.001), and lower mean eGDR (- 3.98 ± 1.07; P < 0.001).
Compared to BMI and insulin requirements, classical surrogates of insulin resistance, eGDR is a suitable and superior thrombotic risk indicator in T1D.
ISRCTN4081115; registered 27 June 2017.
确定估算的葡萄糖处置率（eGDR）作为 1 型糖尿病（T1D）患者血栓形成生物标志物候选标志物的效用。
我们重新分析了来自两项先前 RCT 的 T1D 患者亚组的基线预处理数据，其中包括一组血栓形成标志物，包括纤维蛋白原、组织因子（TF）活性和纤溶酶原激活物抑制剂（PAI）-1，以及 TNFα和临床因素（年龄、T1D 持续时间、HbA1c、胰岛素需求、BMI、血压和 eGDR）。我们采用单变量线性回归模型研究临床参数与 eGDR 与血栓形成生物标志物之间的关联。
纳入 32 名患者[平均年龄 31 ± 7 岁，HbA1c 58 ± 9 mmol/mol（7.5 ± 0.8%），eGDR 7.73 ± 2.61]。eGDR 与纤维蛋白原（P < 0.001）、PAI-1 浓度（P = 0.005）和 TF 活性（P = 0.020）呈负相关，但与 TNFα水平无相关性（P = 0.881）。我们确定了两组表现出明显不同特征的患者；56%（n = 18）被归类为“高风险”，其纤维蛋白原显著升高（+ 1514 ± 594 μg/mL；P < 0.001）、TF 活性（+ 59.23 ± 9.42 pmol/mL；P < 0.001）和 PAI-1（+ 8.48 ± 1.58 pmol/dL；P < 0.001）、HbA1c 浓度（+ 14.20 ± 1.04 mmol/mol；P < 0.001）、年龄（+ 7 ± 3 岁；P < 0.001）、糖尿病持续时间（15 ± 2 年；P < 0.001）、BMI（+ 7.66 ± 2.61 kg/m；P < 0.001）和平均 eGDR 降低（- 3.98 ± 1.07；P < 0.001）。
与 BMI 和胰岛素需求相比，作为胰岛素抵抗的经典替代指标，eGDR 是 T1D 中一种合适且优越的血栓形成风险指标。
ISRCTN4081115；于 2017 年 6 月 27 日注册。
