Qi Yicheng, Li Xiaoyong, Liu Yu, Wang Meng, Wu Yiming, Su Qing, Qin Li, Ma Jing
Department of Endocrinology and Metabolism, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Endocrinology and Metabolism, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Nutr Diabetes. 2025 Feb 5;15(1):3. doi: 10.1038/s41387-025-00357-y.
It is important to detect the predictors of prediabetes progressing to diabetes. Although polyols affect glycometabolism, little is known about the association between fasting serum polyol levels of participants with habitual diet and the risk of prediabetes progressing to type 2 diabetes.
In this nested case-control study, 180 participants who developed from prediabetes to type 2 diabetes (progressors), and 180 matched controls (non-progressors) with prediabetes during a 3.5-year follow-up were enrolled. The baseline levels of serum polyols in the fasting state were quantified using time-of-flight mass spectrometry. Multivariate conditional logistic regression was performed to assess the effects of the differential polyol levels on the risk of incident diabetes from prediabetes.
The baseline fasting xylitol levels, but not sorbitol or erythritol levels, were higher in non-progressors than in progressors (P < 0.001). Non-progressors, in comparison with progressors, had significantly higher proportions within the third tertile of xylitol levels (71/180 non-progressors [39.4%] vs. 49/180 progressors [27.2%]). After adjusting for potential confounders, the odds ratio of risk for incident diabetes in the highest tertile of xylitol levels was 0.338 (95% confidence interval 0.182-0.628), when compared with those in the lowest tertile. In addition, the association between xylitol levels and incident diabetes was persistent in those with fasting hyperglycemia and both fasting and 2h-post-glucose-load hyperglycemia, but not in the isolated 2h-post-glucose-load hyperglycemia.
Elevated baseline fasting serum xylitol levels are associated with a lower risk of prediabetes progressing to diabetes. This association was particularly evident in those with fasting hyperglycemia. These findings suggest that fasting serum xylitol levels may serve as an important predictor and protective factor against the development of diabetes.
检测糖尿病前期进展为糖尿病的预测因素很重要。尽管多元醇会影响糖代谢，但关于习惯性饮食参与者的空腹血清多元醇水平与糖尿病前期进展为2型糖尿病风险之间的关联，人们知之甚少。
在这项巢式病例对照研究中，纳入了180名从糖尿病前期发展为2型糖尿病的参与者（进展者），以及180名在3.5年随访期间与之匹配的糖尿病前期对照者（非进展者）。使用飞行时间质谱法定量空腹状态下血清多元醇的基线水平。进行多变量条件逻辑回归，以评估不同多元醇水平对糖尿病前期发生糖尿病风险的影响。
非进展者的基线空腹木糖醇水平高于进展者，而山梨醇或赤藓糖醇水平则无此差异（P < 0.001）。与进展者相比，非进展者在木糖醇水平的第三个三分位数中的比例显著更高（71/180名非进展者[39.4%]对49/180名进展者[27.2%]）。在调整潜在混杂因素后，与最低三分位数者相比，木糖醇水平最高三分位数者发生糖尿病的风险优势比为0.338（95%置信区间0.182 - 0.628）。此外，木糖醇水平与新发糖尿病之间的关联在空腹血糖升高者以及空腹和葡萄糖负荷后2小时血糖均升高者中持续存在，但在单纯葡萄糖负荷后2小时血糖升高者中不存在。
空腹血清木糖醇基线水平升高与糖尿病前期进展为糖尿病的风险较低相关。这种关联在空腹血糖升高者中尤为明显。这些发现表明，空腹血清木糖醇水平可能是糖尿病发生的重要预测指标和保护因素。
