Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
Department of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Cardiovasc Diabetol. 2021 Jul 28;20(1):157. doi: 10.1186/s12933-021-01351-1.
The fibroblast growth factor (FGF) 21-adiponectin pathway is involved in the regulation of insulin resistance. However, the relationship between the FGF21-adiponectin pathway and type 2 diabetes in humans is unclear. Here, we investigated the association of FGF21/adiponectin ratio with deterioration in glycemia in a prospective cohort study.
We studied 6361 subjects recruited from the prospective Shanghai Nicheng Cohort Study in China. The association between baseline FGF21/adiponectin ratio and new-onset diabetes and incident prediabetes was evaluated using multiple logistic regression analysis.
At baseline, FGF21/adiponectin ratio levels increased progressively with the deterioration in glycemic control from normal glucose tolerance to prediabetes and diabetes (p for trend < 0.001). Over a median follow-up of 4.6 years, 195 subjects developed new-onset diabetes and 351 subjects developed incident prediabetes. Elevated baseline FGF21/adiponectin ratio was a significant predictor of new-onset diabetes independent of traditional risk factors, especially in subjects with prediabetes (odds ratio, 1.367; p = 0.001). Moreover, FGF21/adiponectin ratio predicted incident prediabetes (odds ratio, 1.185; p = 0.021) while neither FGF21 nor adiponectin were independent predictors of incident prediabetes (both p > 0.05). Furthermore, net reclassification improvement and integrated discrimination improvement analyses showed that FGF21/adiponectin ratio provided a better performance in diabetes risk prediction than the use of FGF21 or adiponectin alone.
FGF21/adiponectin ratio independently predicted the onset of prediabetes and diabetes, with the potential to be a useful biomarker of deterioration in glycemia.
成纤维细胞生长因子 (FGF) 21-脂联素途径参与胰岛素抵抗的调节。然而，人类中 FGF21-脂联素途径与 2 型糖尿病的关系尚不清楚。在这里，我们在一项前瞻性队列研究中研究了 FGF21/脂联素比值与血糖恶化的关系。
我们研究了中国前瞻性上海倪城队列研究中招募的 6361 名受试者。使用多变量逻辑回归分析评估基线 FGF21/脂联素比值与新发糖尿病和新发糖尿病前期的关系。
在基线时，FGF21/脂联素比值水平随着血糖控制从正常糖耐量到糖尿病前期和糖尿病的恶化而逐渐升高（趋势检验 < 0.001）。在中位随访 4.6 年后，195 名受试者发生新发糖尿病，351 名受试者发生新发糖尿病前期。基线升高的 FGF21/脂联素比值是新诊断糖尿病的独立预测因素，独立于传统危险因素，尤其是在糖尿病前期患者中（比值比，1.367；p = 0.001）。此外，FGF21/脂联素比值预测新发糖尿病前期（比值比，1.185；p = 0.021），而 FGF21 或脂联素均不是新发糖尿病前期的独立预测因素（均 p > 0.05）。此外，净重新分类改善和综合鉴别改善分析表明，FGF21/脂联素比值在预测糖尿病风险方面的表现优于单独使用 FGF21 或脂联素。
FGF21/脂联素比值独立预测了糖尿病前期和糖尿病的发生，具有作为血糖恶化的有用生物标志物的潜力。
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