Prospective association between fasting NEFA and type 2 diabetes: impact of post-load glucose.
Prospective association between fasting NEFA and type 2 diabetes: impact of post-load glucose.
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DOI：
10.1007/s00125-010-1657-4
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发表时间：
2010-05
期刊：
影响因子：
8.2
通讯作者：
Wagenknecht, L. E.
中科院分区：
文献类型：
--
作者：
Il'yasova, D.;Wang, F.;D'Agostino, R. B., Jr.;Hanley, A.;Wagenknecht, L. E.
空腹非酯化游离脂肪酸（空腹NEFA）升高被认为会促进2型糖尿病。三项前瞻性研究支持这一概念，显示糖尿病风险增加与空腹NEFA相关。然而，空腹NEFA和糖尿病代谢预测因子之间强的横截面相关性可能会混淆这些前瞻性关联。为了验证这一假设，我们使用了胰岛素抵抗动脉粥样硬化研究（IRAS）的队列数据。在IRAS队列（n=902，145例事件病例）中，我们检查了9个代谢变量对空腹NEFA-糖尿病相关性的混杂效应：2小时血糖（2 hG），空腹血糖，体重指数（BMI），腰围，腰臀比，体重，胰岛素敏感性（SI），空腹胰岛素和急性胰岛素反应。我们比较了将每个代谢变量纳入逻辑回归模型之前和之后空腹NEFA的比值比（经过对数转换并根据年龄、性别、种族和临床进行调整）。三个变量（2 hG、BMI和SI）与空腹NEFA横截面相关（r≥0.1，p<0.05）。未经代谢预测因素校正，空腹NEFA水平与糖尿病风险呈正相关：OR=1.37（0.87-2.15）/单位对数标度。除AIR外，所有代谢变量均显示混杂因素。纳入2 hG逆转了正相关[OR=0.50（0.30-0.82）]，而其他预测因子将相关性降至零。最终模型包括与基线空腹NEFA（2 hG，BMI，SI）和人口统计学变量相关的参数，OR =0.47（0.27-0.81）。我们的研究结果表明，2 hG强烈混淆空腹NEFA和糖尿病之间的前瞻性关联;仔细调整空腹NEFA水平与糖尿病风险呈负相关。
Elevated fasting non-esterified free fatty acids (fasting NEFA) are thought to promote type 2 diabetes. Three prospective studies support this concept, showing increased diabetes risk associated with fasting NEFA. However, these prospective associations may be confounded by strong cross-sectional correlations between fasting NEFA and metabolic predictors of diabetes. To examine this assumption, we used cohort data from the Insulin Resistance Atherosclerosis Study (IRAS). Within the IRAS cohort (n=902, 145 incident cases), we examined nine metabolic variables for their confounding effect on the fasting NEFA-diabetes association: 2-hour glucose (2hG), fasting plasma glucose, body mass index (BMI), waist circumference, waist-to-hip ratio, weight, insulin sensitivity (SI), fasting insulin, and acute insulin response. We compared odds ratios for fasting NEFA (log-transformed and adjusted for age, gender, ethnicity, and clinic) before and after inclusion of each metabolic variable into a logistic regression model. Three variables (2hG, BMI, and SI) cross-sectionally correlated with fasting NEFA (r≥0.1, p<0.05). Unadjusted for metabolic predictors, fasting NEFA levels were positively associated with diabetes risk: OR=1.37 (0.87–2.15) per unit on a log-scale. All metabolic variables except AIR showed confounding. Inclusion of 2hG reversed the positive association [OR=0.50 (0.30–0.82)], whereas other predictors reduced the association to the null. The final model included the parameters correlated with baseline fasting NEFA (2hG, BMI, SI) and the demographic variables resulting in OR =0.47 (0.27–0.81). Our results indicate that 2hG strongly confounds the prospective association between fasting NEFA and diabetes; carefully adjusted fasting NEFA levels are inversely associated with diabetes risk.
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DOI：
10.1152/ajpendo.2000.279.1.e146
发表时间：
2000-07-01
影响因子：
5.1
作者：
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影响因子：
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