Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults.
Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults.
复制标题
高血压成人血清碱性磷酸酶水平与新发糖尿病的风险
DOI：
10.1186/s12933-020-01161-x
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发表时间：
2020-10-24
影响因子：
9.3
通讯作者：
Qin X
中科院分区：
文献类型：
--
作者：
Zhang Y;Zhou C;Li J;Zhang Y;Xie D;Liang M;Wang B;Song Y;Wang X;Huo Y;Hou FF;Xu X;Qin X
碱性磷酸酶（ALP）和糖尿病之间的关系仍然不确定。我们的研究旨在调查高血压成人血清碱性磷酸酶与新发糖尿病风险的前瞻性关系，并探索可能的效应调节剂。中国卒中一级预防试验（CSPPT）共纳入了14，393例基线时具有可用ALP测量值且无糖尿病和肝病的高血压患者。主要结局为新发糖尿病，定义为随访期间医生诊断的糖尿病或使用降糖药物，或退出访视时空腹血糖≥ 7.0 mmol/L。次要研究结局是新发空腹血糖受损（IFG），定义为基线时FG < 6.1 mmol/L，退出访视时≥ 6.1但< 7.0 mmol/L。在平均4.5年的随访中，1549名（10.8%）参与者患上了糖尿病。总体而言，血清ALP与新发糖尿病（每SD增量，校正OR，1.07; 95% CI：1.01，1.14）和新发IFG（每SD增量，校正OR，1.07; 95% CI：1.02，1.14）的风险呈正相关。此外，基线ALP与基线ALP之间存在更强的正相关性，在总同型半胱氨酸（tHcy）< 10 μmol/L的受试者中发现新发糖尿病患者（每SD增量）（校正OR，1.24; 95% CI：1.10，1.40 vs. ≥ 10 μmol/L：校正OR，1.03; 95% CI：0.96，1.10; P-相互作用= 0.007）或FG ≥ 5.9 mmol/L（校正OR，1.16; 95% CI：1.07，1.27 vs. < 5.9 mmol/L：校正OR，1.00; 95% CI：0.93，1.08; P-相互作用= 0.009）在非糖尿病高血压人群中，血清ALP升高与新发糖尿病风险增加显著相关，特别是在tHcy水平较低或FG水平较高的患者中。临床试验注册-URL试验注册：NCT 00794885（clinicaltrials.gov）。2008年11月20日注册。
The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG < 6.1 mmol/L at baseline and ≥ 6.1 but < 7.0 mmol/L at the exit visit. Over a median of 4.5 years follow-up, 1549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95% CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95% CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) < 10 μmol/L (adjusted OR, 1.24; 95% CI: 1.10, 1.40 vs. ≥ 10 μmol/L: adjusted OR, 1.03; 95% CI: 0.96, 1.10; P-interaction = 0.007) or FG ≥ 5.9 mmol/L (adjusted OR, 1.16; 95% CI: 1.07, 1.27 vs. < 5.9 mmol/L: adjusted OR, 1.00; 95% CI: 0.93, 1.08; P-interaction = 0.009) In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels. Clinical Trial Registration-URL Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.
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