Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2022 Nov;30(11):2294-2306. doi: 10.1002/oby.23549. Epub 2022 Sep 25.
OBJECTIVE: The mechanisms linking obesity to type 2 diabetes (T2D) are not fully understood. This study aimed to identify obesity-related metabolomic signatures (MESs) and evaluated their relationships with incident T2D. METHODS: In a nested case-control study of 2076 Chinese adults, 140 plasma metabolites were measured at baseline, linear regression was applied with the least absolute shrinkage and selection operator to identify MESs for BMI and waist circumference (WC), and conditional logistic regression was applied to examine their associations with T2D risk. RESULTS: A total of 32 metabolites associated with BMI or WC were identified and validated, among which 14 showed positive associations and 3 showed inverse associations with T2D; 8 and 18 metabolites were selected to build MESs for BMI and WC, respectively. Both MESs showed strong linear associations with T2D: odds ratio (95% CI) comparing extreme quartiles was 4.26 (2.00-9.06) for BMI MES and 9.60 (4.22-21.88) for WC MES (both p-trend < 0.001). The MES-T2D associations were particularly evident among individuals with normal WC: odds ratio (95% CI) reached 6.41 (4.11-9.98) for BMI MES and 10.38 (6.36-16.94) for WC MES. Adding MESs to traditional risk factors and plasma glucose improved C statistics from 0.79 to 0.83 (p < 0.001). CONCLUSIONS: Multiple obesity-related metabolites and MESs strongly associated with T2D in Chinese adults were identified.
目的:肥胖与 2 型糖尿病(T2D)之间的关联机制尚未完全阐明。本研究旨在确定与肥胖相关的代谢组学特征(MES),并评估其与 T2D 发病风险的关系。
方法:在一项对 2076 名中国成年人的巢式病例对照研究中,基线时测量了 140 种血浆代谢物,应用最小绝对收缩和选择算子(LASSO)线性回归确定 BMI 和腰围(WC)的 MES,应用条件 logistic 回归检验其与 T2D 风险的关系。
结果:共鉴定和验证了 32 种与 BMI 或 WC 相关的代谢物,其中 14 种与 T2D 呈正相关,3 种呈负相关;分别为 BMI 和 WC 构建 MES 选择了 8 种和 18 种代谢物。两种 MES 均与 T2D 呈强线性关联:BMI MES 极端四分位组比较的比值比(95%CI)为 4.26(2.00-9.06),WC MES 为 9.60(4.22-21.88)(均 p 趋势 <0.001)。MES-T2D 关联在 WC 正常的个体中更为明显:BMI MES 的比值比(95%CI)为 6.41(4.11-9.98),WC MES 为 10.38(6.36-16.94)。将 MES 加入传统危险因素和血浆葡萄糖可将 C 统计量从 0.79提高到 0.83(p <0.001)。
结论:在中国成年人中确定了与肥胖相关的多种代谢物和 MES,它们与 T2D 密切相关。
Obesity (Silver Spring). 2022-11
Zhonghua Yu Fang Yi Xue Za Zhi. 2016-4
BMC Public Health. 2012-9-1
Diabetes Res Clin Pract. 2017-12-8
Hist Philos Life Sci. 2024-10-30
J Transl Med. 2023-6-12
Diabetes Care. 2022-5-1
Lancet Diabetes Endocrinol. 2021-6
Circ Res. 2020-5-22
Lancet Diabetes Endocrinol. 2019-7-10