Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Diabetes Obes Metab. 2024 Jun;26(6):2092-2101. doi: 10.1111/dom.15514. Epub 2024 Mar 11.
To determine the magnitude of the association between abdominal adiposity and low-grade inflammation in persons with recently diagnosed type 2 diabetes (T2D) and to determine to what extent this association is mediated by low physical activity level, hyperinsulinaemia, hyperglycaemia, dyslipidaemia, hypertension, and comorbidities.
We measured waist circumference, clinical characteristics, and inflammatory markers i.e. tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP), in >9000 persons with recently diagnosed T2D. We applied multiple mediation analysis using structural equation modelling, with adjustment for age and sex.
Waist circumference as a proxy for abdominal adiposity was positively associated with all inflammatory markers. Hence, a one-standard deviation (SD) increase in waist circumference (SD = 15 cm) was associated with a 22%, 35%, and 46% SD increase in TNF-α (SD = 1.5 pg/mL), IL-6 (SD = 4.4 pg/mL), and hsCRP (SD = 6.9 mg/L), respectively. The level of hyperinsulinaemia assessed by fasting C-peptide was quantitatively the most important mediator, accounting for 9%-25% of the association between abdominal adiposity and low-grade inflammation, followed by low physical activity (5%-7%) and high triglyceride levels (2%-6%). Although mediation of adiposity-induced inflammation by greater comorbidity and higher glycated haemoglobin levels reached statistical significance, their impact was minor (1%-2%).
In persons with recently diagnosed T2D, there was a clear association between abdominal adiposity and low-grade inflammation. A considerable part (20%-40%) of this association was mediated by other factors, with hyperinsulinaemia as a potentially important driver of adiposity-induced inflammation in T2D.
确定在新近诊断的 2 型糖尿病（T2D）患者中，腹部肥胖与低度炎症之间的关联程度，并确定这种关联在多大程度上是由低体力活动水平、高胰岛素血症、高血糖、血脂异常、高血压和合并症引起的。
我们在 >9000 名新近诊断的 T2D 患者中测量了腰围、临床特征和炎症标志物，即肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和高敏 C 反应蛋白（hsCRP）。我们使用结构方程模型进行了多次中介分析，调整了年龄和性别。
腰围作为腹部肥胖的替代指标与所有炎症标志物呈正相关。因此，腰围增加一个标准差（SD）（SD=15cm）与 TNF-α（SD=1.5pg/mL）、IL-6（SD=4.4pg/mL）和 hsCRP（SD=6.9mg/L）分别增加 22%、35%和 46%SD。空腹 C 肽评估的高胰岛素血症水平是最重要的定量中介因素，占腹部肥胖与低度炎症之间关联的 9%-25%，其次是低体力活动（5%-7%）和高甘油三酯水平（2%-6%）。虽然肥胖引起的炎症通过更高的合并症和更高的糖化血红蛋白水平的中介作用达到了统计学意义，但它们的影响很小（1%-2%）。
在新近诊断的 T2D 患者中，腹部肥胖与低度炎症之间存在明显的关联。这种关联的相当一部分（20%-40%）是由其他因素介导的，其中高胰岛素血症是 T2D 中肥胖引起的炎症的一个潜在重要驱动因素。
