Ultrasound Department, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, 261000, China.
Cardiac Critical Care and Rehabilitation Department, Weifang People's Hospital, Weifang, Shandong, 261000, China.
BMC Endocr Disord. 2024 Sep 11;24(1):186. doi: 10.1186/s12902-024-01713-2.
In the past, there has been a clear conclusion regarding the sole impact of serum neurofilament light chain (sNfL) levels or type 2 diabetes mellitus (DM) on the risk of death. However, the combined effect of sNfL levels and type 2 DM on all-cause and cardiovascular mortality is still uncertain.
This study was a prospective cohort study based on data from the National Health and Nutrition Examination Survey (NHANES). The sNfL levels were measured through immunological methods using blood samples collected during the survey. The diagnosis of diabetes was based on rigorous criteria, and participants' mortality data were followed up until December 31, 2019. Firstly, we separately examined the effects of sNfL and type 2 DM on all-cause and cardiovascular mortality, and finally studied the comprehensive impact of the combination of sNfL and type 2 DM on the risk of mortality. Cumulative Kaplan-Meier curves, multivariate logistic regression and sensitivity analysis were incorporated throughout the entire study.
Participants in the highest quartile of sNfL were observed. Multivariable COX regression model showed that increased sNfL levels and type 2 DM were respectively associated with an increased risk of all-cause and cardiovascular mortality. Furthermore, elevated sNfL levels were significantly associated with an increased risk of all-cause mortality and cardiovascular mortality after adjustment for confounding factors. When considering both elevated sNfL levels and type 2 DM, individuals had a significantly increased risk of mortality. Sensitivity analysis confirmed the robustness of the findings.
These results suggest that elevated levels of sNfL and type 2 DM are associated with an increased risk of all-cause and cardiovascular mortality, and that participants with increased sNfL levels associated with type 2 DM have higher all-cause mortality and cardiovascular mortality.
过去，关于血清神经丝轻链（sNfL）水平或 2 型糖尿病（DM）对死亡风险的单一影响已有明确结论。然而，sNfL 水平与 2 型 DM 对全因和心血管死亡率的综合影响仍不确定。
本研究是一项基于国家健康和营养调查（NHANES）数据的前瞻性队列研究。sNfL 水平通过在调查期间采集的血液样本，采用免疫学方法进行测量。糖尿病的诊断基于严格的标准，并且对参与者的死亡率数据进行了随访，直至 2019 年 12 月 31 日。首先，我们分别研究了 sNfL 和 2 型 DM 对全因和心血管死亡率的影响，最后研究了 sNfL 和 2 型 DM 联合对死亡率风险的综合影响。整个研究中都纳入了累积 Kaplan-Meier 曲线、多变量逻辑回归和敏感性分析。
观察到 sNfL 最高四分位数的参与者。多变量 COX 回归模型显示，sNfL 水平升高和 2 型 DM 分别与全因和心血管死亡率增加相关。此外，校正混杂因素后，sNfL 水平升高与全因死亡率和心血管死亡率增加显著相关。当同时考虑升高的 sNfL 水平和 2 型 DM 时，个体的死亡风险显著增加。敏感性分析证实了研究结果的稳健性。
这些结果表明，sNfL 水平升高和 2 型 DM 与全因和心血管死亡率增加相关，并且与 2 型 DM 相关的 sNfL 水平升高的参与者具有更高的全因死亡率和心血管死亡率。
