Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China.
Front Endocrinol (Lausanne). 2023 Mar 30;14:1143590. doi: 10.3389/fendo.2023.1143590. eCollection 2023.
The potential role of neprilysin (NEP) in glucose metabolism has been found by basic studies but lacks population evidence. The objective of this study was to examine the association between serum NEP and diabetes in Chinese adults.
In a prospective longitudinal cohort study - the Gusu cohort (n=2,286, mean age: 52 years, 61.5% females), the cross-sectional, longitudinal, and prospective associations between serum NEP and diabetes were systemically examined by logistic regression adjusting for conventional risk factors. Serum NEP was measured at baseline using commercial ELISA assays. Fasting glucose was repeatedly measured 4 years apart.
The cross-sectional analysis found a positive association between serum NEP and fasting glucose at baseline (β=0.08, =0.004 for log-transformed NEP). This association persisted after controlling for the dynamic risk profiles during follow-up (β=0.10, =0.023 for log-transformed NEP). The prospective analysis found that a higher level of serum NEP at baseline was associated with a higher risk of diabetes during follow-up (OR=1.79, =0.039 for log-transformed NEP).
Serum NEP was not only associated with prevalent diabetes but also predicted the future risk of diabetes development in Chinese adults, independent of many behavioral and metabolic factors. Serum NEP may be a predictor and even a new therapeutic target for diabetes. However, the casualty and mechanisms of NEP in the development of diabetes require further investigation.
基础研究发现，脑啡肽酶（NEP）在葡萄糖代谢中具有潜在作用，但缺乏人群证据。本研究旨在探讨中国成年人血清 NEP 与糖尿病之间的关系。
在一项前瞻性纵向队列研究——姑苏队列（n=2286，平均年龄 52 岁，61.5%为女性）中，通过逻辑回归调整常规危险因素，系统地检验了血清 NEP 与糖尿病之间的横断面、纵向和前瞻性关联。使用商业 ELISA 检测试剂盒在基线时测量血清 NEP。空腹血糖在 4 年的时间间隔内重复测量。
横断面分析发现，基线时血清 NEP 与空腹血糖呈正相关（β=0.08，=0.004，用于 log 转换的 NEP）。在随访期间控制动态风险特征后，这种关联仍然存在（β=0.10，=0.023，用于 log 转换的 NEP）。前瞻性分析发现，基线时较高的血清 NEP 水平与随访期间糖尿病的风险增加相关（OR=1.79，=0.039，用于 log 转换的 NEP）。
血清 NEP 不仅与现患糖尿病相关，而且独立于许多行为和代谢因素，预测中国成年人未来发生糖尿病的风险。血清 NEP 可能是糖尿病的预测指标，甚至是新的治疗靶点。然而，NEP 在糖尿病发展中的因果关系和机制需要进一步研究。
