慢性低度炎症参与肥胖与2型糖尿病关系的中介作用：来自美国国家健康与营养检查调查（NHANES）的结果
The mediating role of chronic low-grade inflammation participation in the relationship between obesity and type 2 diabetes: findings from the NHANES.
作者信息
Li Ping, Qiao Qincheng, Nie Chenyu, Guo Xinghong, Wang Chuan, Liu Jinbo, Liang Kai
机构信息
Department of Endocrinology and Metabolism, Qilu Hospital, Shandong University, Jinan, 250012, China.
The First Clinical Medical College, Cheeloo College of Medicine, Shandong University, Jinan, China.
出版信息
BMC Endocr Disord. 2024 Jul 31;24(1):130. doi: 10.1186/s12902-024-01671-9.
BACKGROUND
Chronic low-grade inflammation may mediate the relationship between obesity and diabetes, yet clinical research in this area remains scarce. Thus, this study aimed to explore the mediating role of chronic low-grade inflammation in this relationship using the National Health and Nutrition Examination Survey (NHANES).
METHODS
This study involved 2,482 participants enrolled in the NHANES between 2005 and 2016. Based on the complex sampling survey weights of NHANES, logistic regression models were fitted, adjusting for various covariates to investigate the relationship between BMI, INFLA score, and diabetes. Moreover, weighted quantile sum (WQS) regression models were fitted to analyze the proportional contribution of individual components within the INFLA score. Finally, mediation analysis was conducted to quantitatively assess the magnitude of the mediating effect of the INFLA score on the relationship between BMI and diabetes.
RESULTS
After adjusting for all potential confounding factors, a significant positive correlation was noted between INFLA score and diabetes [OR (95% CI), 1.038(1.003-1.075), p = 0.035]. Additionally, a significant positive correlation was observed between the high INFLA group and diabetes compared to the low INFLA group [OR (95% CI), 1.599(1.031-2.481), p = 0.037]. WQS regression models revealed that the proportional contributions of C-reactive protein, white blood cell count, platelet count, and neutrophil-to-lymphocyte ratio (NLR) were 55.5%, 34.8%, 8.46%, and 1.19%, respectively. Finally, the results of the mediation analysis indicated that the indirect effect of the INFLA score accounted for 10.20%.
CONCLUSIONS
Chronic low-grade inflammation was associated with diabetes and partially mediates the relationship between obesity and diabetes.
背景
慢性低度炎症可能介导肥胖与糖尿病之间的关系，但该领域的临床研究仍然匮乏。因此，本研究旨在利用美国国家健康与营养检查调查（NHANES）探讨慢性低度炎症在这种关系中的中介作用。
方法
本研究纳入了2005年至2016年间参加NHANES的2482名参与者。基于NHANES的复杂抽样调查权重，拟合逻辑回归模型，对各种协变量进行调整，以研究体重指数（BMI）、炎症（INFLA）评分与糖尿病之间的关系。此外，拟合加权分位数和（WQS）回归模型，以分析INFLA评分中各个成分的比例贡献。最后，进行中介分析，以定量评估INFLA评分对BMI与糖尿病之间关系的中介效应大小。
结果
在调整所有潜在混杂因素后，发现INFLA评分与糖尿病之间存在显著正相关[比值比（95%可信区间），1.038（1.003 - 1.075），P = 0.035]。此外，与低INFLA组相比，高INFLA组与糖尿病之间也存在显著正相关[比值比（95%可信区间），1.599（1.031 - 2.481），P = 0.037]。WQS回归模型显示，C反应蛋白、白细胞计数、血小板计数和中性粒细胞与淋巴细胞比值（NLR）的比例贡献分别为55.5%、34.8%、8.46%和1.19%。最后，中介分析结果表明，INFLA评分的间接效应占10.20%。
结论
慢性低度炎症与糖尿病相关，并部分介导肥胖与糖尿病之间的关系。
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