Plasma fetuin-A levels and the risk of type 2 diabetes.
Plasma fetuin-A levels and the risk of type 2 diabetes.
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DOI：
10.2337/db08-0538
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发表时间：
2008-10
期刊：
影响因子：
7.7
通讯作者：
Schulze, Matthias B.
中科院分区：
文献类型：
--
作者：
Stefan, Norbert;Fritsche, Andreas;Weikert, Cornelia;Boeing, Heiner;Joost, Hans-Georg;Haring, Hans-Ulrich;Schulze, Matthias B.
肝脏分泌的蛋白质胎球蛋白-A诱导动物的胰岛素抵抗，并且循环胎球蛋白-A在人类的胰岛素抵抗和脂肪肝中升高。我们在一项大型前瞻性人群研究中调查了血浆胎球蛋白A水平是否能预测2型糖尿病的发病率。研究设计和方法-欧洲癌症和营养前瞻性研究（EPIC）-波茨坦研究中的病例队列研究，包括27，548名受试者。我们随机选择了2,500名受试者，其中2,164人在基线时无糖尿病，并有既往史、人体测量和代谢数据进行分析。在7年随访期间，在整个队列中确定的849例新发糖尿病病例受试者中，703例在类似排除后仍进行分析。血浆胎球蛋白A水平与年龄校正后的糖尿病风险呈正相关（极端五分位数的相对风险[RR]为1.75 [95%CI 1.32-2.31]; 10 μg/ml的RR为1.04 [1.03-1.06]）。校正性别、BMI、腰围和生活方式风险因素后，相关性仍然显著（10 μg/ml的RR为1.03 [1.01-1.06]）。葡萄糖、甘油三酯、HDL胆固醇、A1 C、γ-谷氨酰转移酶或高敏C反应蛋白的校正或这些生物标志物的相互校正未明显改变该结果（10 μg/ml完全校正模型的RR为1.05 [1.02-1.07]）。此外，胎球蛋白-A与糖尿病风险增加相关，特别是在血糖升高的个体中。结论：我们的数据提示胎球蛋白A是2型糖尿病的独立危险因素。
OBJECTIVE—The liver-secreted protein fetuin-A induces insulin resistance in animals, and circulating fetuin-A is elevated in insulin resistance and fatty liver in humans. We investigated whether plasma fetuin-A levels predict the incidence of type 2 diabetes in a large prospective, population-based study. RESEARCH DESIGN AND METHODS—A case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study comprising 27,548 subjects was designed. We randomly selected a subcohort of 2,500 individuals of whom 2,164 were diabetes free at baseline and had anamnestic, anthropometrical, and metabolic data for analysis. Of the 849 incident diabetic case subjects identified in the full cohort during 7 years of follow-up, 703 remained for analyses after similar exclusions. RESULTS—Plasma fetuin-A levels were positively associated with diabetes risk after adjustment for age (relative risk [RR] for extreme quintiles 1.75 [95% CI 1.32–2.31]; RR for 10 μg/ml 1.04 [1.03–1.06]). The association remained significant after adjustment for sex, BMI, waist circumference, and lifestyle risk factors (RR for 10 μg/ml 1.03 [1.01–1.06]). Adjustment for glucose, triglycerides, HDL cholesterol, A1C, γ-glutamyltransferase, or high-sensitivity C-reactive protein or mutual adjustment for these biomarkers did not appreciably change this result (RR for 10 μg/ml full adjusted model 1.05 [1.02–1.07]). Furthermore, fetuin-A was associated with increased diabetes risk particularly in individuals with elevated plasma glucose. CONCLUSIONS—Our data suggest that fetuin-A is an independent risk factor of type 2 diabetes.
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