Boughanem Hatim, de Larriva Antonio Pablo Arenas, Camargo Antonio, Torres-Peña José D, Ojeda-Rodriguez Ana, Alcala-Diaz Juan F, Romero-Cabrera Juan L, Rangel-Zuñiga Oriol Alberto, Rodríguez-Cantalejo Fernando, Soehnlein Oliver, Macias-Gonzalez Manuel, Tinahones Francisco J, Perez-Martinez Pablo, Delgado-Lista Javier, López-Miranda José
Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sofía, 14004 Cordoba, Spain.
Department of Medical and Surgical Sciences, Universidad de Cordoba, 14004 Cordoba, Spain.
J Clin Endocrinol Metab. 2025 May 19;110(6):1550-1558. doi: 10.1210/clinem/dgae736.
Numerous studies have reported an association between neutrophils and type 2 diabetes mellitus (T2DM), although this relationship remains unclear.
To investigate the interaction of neutrophils and a dietary intervention on T2DM incidence after 60 months of follow-up.
A comprehensive analysis was conducted on the framework of the CORDIOPREV study, which included 462 patients without T2DM at the beginning of the study, randomly assigned to either a Mediterranean or a low-fat diet; 107 developed T2DM. Absolute neutrophil counts and neutrophil-related ratios were measured.
Kaplan-Meier curves showed that the lowest tertile of basal neutrophils was associated with a reduced likelihood of T2DM incidence when compared to the middle (hazard ratio [HR] = 0.499 [95% CI, 0.287-0.866]) and the highest tertiles (HR = 0.442 [95% CI, 0.255-0.768]) in the overall population, after adjusting for clinical variables. This association only remained significant in patients who followed a Mediterranean diet when comparing the lowest to the middle (HR = 0.423 [95% CI, 0.213-0.842]) and the highest tertiles (HR = 0.371 [95% CI, 0.182-0.762]). The predictive capacity yielded an AUC of 0.711 (95% CI, 0.652-0.769), with neutrophils being the most important variable in the in the model. Decrease in neutrophils over the 60 months was associated with increased insulin sensitivity index (R = -0.31; P = .019), particularly in patients who followed the Mediterranean diet.
These findings suggest that monitoring neutrophils can help prevent the development of T2DM, as a reduction in neutrophil counts could be associated with improved insulin sensitivity. Following a Mediterranean diet might be a potential strategy to reduce the incidence of T2DM by lowering neutrophil levels. Further research is necessary to gain a deeper understanding regarding this mechanism.
众多研究报告了中性粒细胞与2型糖尿病（T2DM）之间的关联，尽管这种关系仍不明确。
研究中性粒细胞与饮食干预对随访60个月后T2DM发病率的相互作用。
在CORDIOPREV研究框架内进行了全面分析，该研究包括462名在研究开始时无T2DM的患者，随机分配至地中海饮食组或低脂饮食组；其中107人患T2DM。测量了绝对中性粒细胞计数和中性粒细胞相关比率。
Kaplan-Meier曲线显示，在调整临床变量后，总体人群中基础中性粒细胞最低三分位数与T2DM发病可能性降低相关，与中间三分位数（风险比[HR]=0.499[95%CI，0.287 - 0.866]）和最高三分位数相比（HR = 0.442[95%CI，0.255 - 0.768]）。当比较最低与中间三分位数（HR = 0.423[95%CI，0.213 - 0.842]）和最高三分位数时（HR = 0.371[95%CI，0.182 - 0.762]），这种关联仅在遵循地中海饮食的患者中仍然显著。预测能力产生的曲线下面积（AUC）为0.711（95%CI，0.652 - 0.769），中性粒细胞是模型中最重要的变量。60个月内中性粒细胞减少与胰岛素敏感性指数增加相关（R = -0.31；P = 0.019），特别是在遵循地中海饮食的患者中。
这些发现表明，监测中性粒细胞有助于预防T2DM的发生，因为中性粒细胞计数减少可能与胰岛素敏感性改善相关。遵循地中海饮食可能是通过降低中性粒细胞水平来降低T2DM发病率的潜在策略。有必要进行进一步研究以更深入了解这一机制。
