Centre for Precision Health, Edith Cowan University, Room 521, Building 21/270 Joondalup Drive, Perth, WA, 6027, Australia.
Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515041, China.
Cardiovasc Diabetol. 2023 Jul 15;22(1):181. doi: 10.1186/s12933-023-01878-5.
Both elevated inflammation and atherogenic dyslipidemia are prominent in young-onset diabetes and are increasingly identified as biologically intertwined processes that contribute to diabetogenesis. We aimed to investigate the age-specific risks of type 2 diabetes (T2D) upon concomitant chronic inflammation and atherogenic dyslipidemia.
Age-stratified Cox regression analysis of the risk of incident diabetes upon co-exposure to time-averaged cumulative high-sensitivity C-reactive protein (CumCRP) and atherogenic index of plasma (CumAIP) among 42,925 nondiabetic participants from a real-world, prospective cohort (Kailuan Study).
During a median 6.41 years of follow-up, 3987 T2D developed. Isolated CumAIP and CumCRP were significantly associated with incident T2D in the entire cohort and across all age subgroups. Both CumAIP and CumCRP were jointly associated with an increased risk of diabetes (P-interaction = 0.0126). Compared to CumAIP < -0.0699 and CumCRP < 1 mg/L, co-exposure to CumAIP ≥ - 0.0699 and CumCRP ≥ 3 mg/L had a significant hazard ratio (HR) [2.55 (2.23-2.92)] after adjusting for socio-demographic, life-style factors, family history of diabetes, blood pressure, renal function and medication use. The co-exposure-associated risks varied greatly by age distribution (P-interaction = 0.0193): < 40 years, 6.26 (3.47-11.28); 40-49 years, 2.26 (1.77-2.89); 50-59 years, 2.51 (2.00-3.16); 60-69 years, 2.48 (1.86-3.30); ≥ 70 years, 2.10 (1.29-3.40). In young adults (< 45 years), both exposures had a significant supra-additive effect on diabetogenesis (relative excess risk due to interaction: 0.80, 95% CI 0.10-1.50).
These findings highlight the need for age-specific combined assessment and management of chronic inflammation and dyslipidemia in primary prevention against T2D, particularly for young adults. The clinical benefit derived from dual-target intervention against dyslipidemia and inflammation will exceed the sum of each part alone in young adults.
炎症升高和动脉粥样硬化性血脂异常在早发糖尿病中很明显，并且越来越被认为是生物学上相互交织的过程，这些过程导致糖尿病的发生。我们旨在研究同时存在慢性炎症和动脉粥样硬化性血脂异常时 2 型糖尿病（T2D）的特定年龄风险。
对来自真实世界前瞻性队列研究（开滦研究）的 42925 名非糖尿病参与者中同时暴露于时间平均累积高敏 C 反应蛋白（CumCRP）和血浆致动脉粥样硬化指数（CumAIP）时发生糖尿病的风险进行年龄分层 Cox 回归分析。
在中位 6.41 年的随访期间，有 3987 例 T2D 发生。在整个队列和所有年龄亚组中，单独的 CumAIP 和 CumCRP 与 T2D 的发生显著相关。CumAIP 和 CumCRP 均与糖尿病风险增加相关（P 交互 = 0.0126）。与 CumAIP < -0.0699 和 CumCRP < 1mg/L 相比，同时暴露于 CumAIP ≥ -0.0699 和 CumCRP ≥ 3mg/L 在调整了社会人口统计学、生活方式因素、糖尿病家族史、血压、肾功能和药物使用后，具有显著的危险比（HR）[2.55（2.23-2.92）]。同时暴露相关的风险因年龄分布而有很大差异（P 交互 = 0.0193）：<40 岁，6.26（3.47-11.28）；40-49 岁，2.26（1.77-2.89）；50-59 岁，2.51（2.00-3.16）；60-69 岁，2.48（1.86-3.30）；≥70 岁，2.10（1.29-3.40）。在年轻成年人（<45 岁）中，两种暴露对糖尿病的发生均有显著的超相加作用（交互归因风险比：0.80，95%CI 0.10-1.50）。
这些发现强调了在 T2D 的一级预防中，需要针对特定年龄进行慢性炎症和血脂异常的联合评估和管理，特别是在年轻成年人中。针对血脂异常和炎症的双重靶向干预带来的临床获益将超过年轻成年人中每个部分的单独获益。
Zotero 插件