Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Endocrine. 2022 Apr;76(1):36-43. doi: 10.1007/s12020-021-02961-1. Epub 2022 Jan 15.
Little research has investigated the correlation of changes in long-term apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) ratio with risk of new-onset type 2 diabetes (T2D) among ordinary people. Therefore, the research took long-term ApoB/ApoA-I ratio trajectories as independent variables for exploring their association with the risk of newly diagnosed T2D.
Altogether 5362 non-diabetic participants with a median age of 49 were enrolled in the cohort study. Their ApoB/ApoA-I ratio trajectories from 2016 to 2019 were analyzed and grouped using group-based trajectory modeling. The Kaplan-Meier approach was employed for calculating the newly diagnosed T2D-related incidence with different ApoB/ApoA-I ratio trajectories. A log-rank test was conducted for testing the presence of statistical difference in new-onset T2D incidence among the different ApoB/ApoA-I ratio trajectory groups. A multivariate Cox proportional hazards regression model was adopted for analyzing how ApoB/ApoA-I ratio trajectory changes affected new-onset T2D.
From 2016 to 2019, 199 patients developed T2D (3% in 3 years). The incidence of T2D was 2.0%, 3.28%, 5.86%, and 6.92% for low, middle, upper, and high ApoB/ApoA-I ratio trajectories, respectively. Following adjustment of underlying confounding factors, in contrast to low ApoB/ApoA-I ratio trajectory, new-onset T2D risk ratios and hazard ratio (HR) (95% confidence intervals [CI]) for the middle lower ApoB/ApoA-I ratio trajectory, and upper middle and high ApoB/ApoA-I ratio trajectories were [HR (95% CI)] 1.35(0.88-2.08), 1.98(1.27-3.09) and 2.42(1.35-4.34), respectively, indicating high and statistically significant risks of T2D.
Variations of the ApoB/ApoA-I ratio trajectory exerted independent effects on the 3-year incidence of T2D. Long-term monitoring on the ApoB/ApoA-I ratio locus may help improve the identification on patients with T2D.
很少有研究调查长期载脂蛋白 B/载脂蛋白 A-I（ApoB/ApoA-I）比值变化与普通人群新发 2 型糖尿病（T2D）风险之间的相关性。因此，本研究以长期 ApoB/ApoA-I 比值轨迹为自变量，探讨其与新诊断 T2D 风险的关系。
本队列研究共纳入 5362 名非糖尿病患者，中位年龄为 49 岁。分析了他们在 2016 年至 2019 年期间的 ApoB/ApoA-I 比值轨迹，并使用基于群组的轨迹建模对其进行分组。采用 Kaplan-Meier 方法计算不同 ApoB/ApoA-I 比值轨迹下新诊断 T2D 相关发病率。对数秩检验用于检验不同 ApoB/ApoA-I 比值轨迹组中 T2D 新发病例发生率的统计学差异。采用多变量 Cox 比例风险回归模型分析 ApoB/ApoA-I 比值轨迹变化如何影响新发 T2D。
2016 年至 2019 年间，199 名患者发生 T2D（3 年内 2.0%）。低、中、高 ApoB/ApoA-I 比值轨迹组的 T2D 发病率分别为 2.0%、3.28%、5.86%和 6.92%。在调整潜在混杂因素后，与低 ApoB/ApoA-I 比值轨迹相比，中低 ApoB/ApoA-I 比值轨迹和中上高 ApoB/ApoA-I 比值轨迹的新发 T2D 风险比和风险比（95%置信区间[CI]）分别为[HR（95%CI）]1.35（0.88-2.08）、1.98（1.27-3.09）和 2.42（1.35-4.34），表明 T2D 的风险较高且具有统计学意义。
ApoB/ApoA-I 比值轨迹的变化对 T2D 3 年发病率有独立影响。长期监测 ApoB/ApoA-I 比值可能有助于提高 T2D 患者的识别能力。
