Chronic inflammation role in the obesity-diabetes association: a case-cohort study.

Chronic inflammation role in the obesity-diabetes association: a case-cohort study.
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DOI:
10.1186/1758-5996-5-31
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发表时间:
2013-06-27
影响因子:
4.8
通讯作者:
Duncan BB
Duncan BB
中科院分区:
医学2区
文献类型:
--
作者:
Luft VC;Schmidt MI;Pankow JS;Couper D;Ballantyne CM;Young JH;Duncan BB

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慢性炎症与肥胖和糖尿病都有关。我们的目的是调查这种炎症在多大程度上有助于肥胖和糖尿病之间的联系。采用病例队列设计,我们在ARIC研究中随访了567名患有糖尿病的中年人和554名未超过9年的中年人。加权考克斯比例风险分析允许对整个队列进行统计推断。肥胖个体与BMI<25 kg/m2的人相比,BMI≥30 kg/m2的人患糖尿病的风险大幅增加。(HR[肥胖]=6.4,95%CI 4.5-9.2),最高年龄组也是如此。腰围(与最低值相比)四分位数(HR[腰围]=8.3,95%CI 5.6-12.3),分析中调整了年龄、性别、种族、研究中心和父母糖尿病史。值得注意的是,进一步调整脂联素和炎症标志物使这些关联的程度减半(HR[肥胖]=3.2,95%CI 2.1-4.7; HR[腰围]=4.2,95%CI 2.8-6.5)。在类似的建模中,通过添加空腹胰岛素而不是这些标志物获得的减毒仅略微更明显HR[肥胖]=2.7,95%CI 1.7-4.1; HR[腰围]=3.6,95%CI 2.3-5.8)。在考虑炎症标志物和脂肪因子后,肥胖-糖尿病相关性显著降低,表明它们在导致肥胖个体成人糖尿病发作的途径中起主要作用。
Chronic inflammation is related to both obesity and diabetes. Our aim was to investigate to what extent this inflammation contributes to the association between obesity and diabetes. Using a case-cohort design, we followed 567 middle-aged individuals who developed diabetes and 554 who did not over 9 years within the ARIC Study. Weighted Cox proportional hazards analyses permitted statistical inference to the entire cohort. Obese individuals (BMI≥30 kg/m2), compared to those with BMI<25 kg/m2, presented a large increased risk of developing diabetes (HR[obesity]=6.4, 95%CI 4.5–9.2), as did those in the highest (compared to the lowest) quartile of waist circumference (HR[waist]=8.3, 95%CI 5.6–12.3), in analyses adjusted for age, gender, ethnicity, study center, and parental history of diabetes. Notably, further adjustment for adiponectin and inflammation markers halved the magnitude of these associations (HR[obesity]=3.2, 95%CI 2.1–4.7; and HR[waist]=4.2, 95%CI 2.8–6.5). In similar modeling, attenuation obtained by adding fasting insulin, instead of these markers, was only slightly more pronounced HR[obesity]=2.7, 95%CI 1.7–4.1; and HR[waist]=3.6, 95%CI 2.3–5.8). The marked decrease in the obesity-diabetes association after taking into account inflammation markers and adipokines indicates their major role in the pathways leading to adult onset of diabetes in obese individuals.
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发表时间: 2003-07-01
期刊: DIABETES
影响因子: 7.7
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发表时间: 2004-09-01
期刊: DIABETES
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发表时间: 2004-03-01
期刊: DIABETES
影响因子: 7.7
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