Total and high-molecular-weight adiponectin and risk of incident diabetes in older people.
Total and high-molecular-weight adiponectin and risk of incident diabetes in older people.
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DOI：
10.2337/dc11-1519
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发表时间：
2012-02
期刊：
影响因子：
16.2
通讯作者：
Mukamal KJ
中科院分区：
文献类型：
--
作者：
Kizer JR;Arnold AM;Benkeser D;Ix JH;Djousse L;Zieman SJ;Barzilay JI;Tracy RP;Mantzoros CS;Siscovick DS;Mukamal KJ
目的：探讨总脂联素、高分子脂联素(HMW)和HMW/总脂联素与老年人糖尿病的关系。总脂联素和HMW脂联素是在一项基于人群的老年人研究中测量的。在3802名受试者中评估了总脂联素、高分子脂联素及其比值与糖尿病发病的关系(n=309)。总脂联素与高分子脂联素呈高度正相关(r=0.94)。三次样条法分析表明，总脂联素和高分子脂联素与新发糖尿病之间的关系不是线性的。具体地说，在调整混杂因素后，总风险比(每标准差0.49[95%可信区间0.39-0.63])和高分子脂联素(0.42[0.32-0.56])分别与糖尿病的数值达到20和10 mg/L存在相似的负相关关系，高于这两个值的相关性处于稳定状态。在对潜在的中介因素(血压、血脂、C反应蛋白和胰岛素抵抗的稳态模型评估[HOMA-IR])进行调整后，这些关联仍然存在。然而，有证据表明HOMA-IR在较低的脂联素范围内相互作用，在胰岛素敏感的参与者中与胰岛素抵抗的参与者之间存在更强的负相关性。HMW/总脂联素比率与预后呈线性调整关系，但这一关系因纳入中介变量而被取消。在这个较老的队列中，总脂联素和高分子脂联素浓度的增加与相对较低的糖尿病风险有关，但随着浓度分别高于20和10毫克/L的进一步增加，这些相关性趋于平稳。在没有胰岛素抵抗的参与者中，风险在较低的范围内降低更明显，这支持脂联素的作用独立于基线高胰岛素血症，但这还需要进一步的研究。
To delineate the associations of total adiponectin, high-molecular-weight (HMW) adiponectin, and the HMW-to-total adiponectin ratio with diabetes in older adults. Total and HMW adiponectin were measured in a population-based study of older adults. The relations of total adiponectin, HMW adiponectin, and their ratio with incident diabetes (n = 309) were assessed in 3,802 individuals. Total and HMW adiponectin were highly correlated (r = 0.94). Analysis using cubic splines revealed that the associations between total and HMW adiponectin and new-onset diabetes were not linear. Specifically, after adjustment for confounders, there were similar inverse relationships for total (hazard ratio per SD 0.49 [95% CI 0.39–0.63]) and HMW adiponectin (0.42 [0.32–0.56]) with diabetes up to values of 20 and 10 mg/L, respectively, above which the associations plateaued. These associations persisted after adjustment for potential mediators (blood pressure, lipids, C-reactive protein, and homeostasis model assessment of insulin resistance [HOMA-IR]). There was, however, evidence of interaction by HOMA-IR in the lower range of adiponectin, with stronger inverse associations among insulin-sensitive than insulin-resistant participants. HMW-to-total adiponectin ratio showed a linear adjusted association with outcome, but this was abolished by inclusion of mediating variables. In this older cohort, increasing concentrations of total and HMW adiponectin were associated with comparably lower risks of diabetes, but these associations leveled off with further increases above concentrations of 20 and 10 mg/L, respectively. The more pronounced risk decreases at the lower range among participants without insulin resistance support a role for adiponectin that is independent of baseline hyperinsulinemia, but this will require further investigation.
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影响因子：
5
作者：
Kizer, Jorge R.;Biggs, Mary L.;Siscovick, David S.
通讯作者：
Siscovick, David S.
影响因子：
16.2
作者：
Cowie CC;Rust KF;Ford ES;Eberhardt MS;Byrd-Holt DD;Li C;Williams DE;Gregg EW;Bainbridge KE;Saydah SH;Geiss LS
通讯作者：
Geiss LS
影响因子：
6.3
作者：
Newman AB;Arnold AM;Sachs MC;Ives DG;Cushman M;Strotmeyer ES;Ding J;Kritchevsky SB;Chaves PH;Fried LP;Robbins J
通讯作者：
Robbins J
影响因子：
4.8
作者：
Pajvani, UB;Hawkins, M;Scherer, PE
通讯作者：
Scherer, PE
影响因子：
16.2
作者：
Snijder, Marieke B.;Heine, Robert J.;Dekker, Jacqueline M.
通讯作者：
Dekker, Jacqueline M.