Additional contribution of emerging risk factors to the prediction of the risk of type 2 diabetes: evidence from the Western New York Study.
Additional contribution of emerging risk factors to the prediction of the risk of type 2 diabetes: evidence from the Western New York Study.
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新出现的风险因素对 2 型糖尿病风险预测的额外贡献：来自纽约西部研究的证据。
DOI：
10.1038/oby.2008.59
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
Donahue,RichardP
中科院分区：
文献类型：
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作者：
Stranges,Saverio;Rafalson,LisaB;Dmochowski,Jacek;Rejman,Karol;Tracy,RussellP;Trevisan,Maurizio;Donahue,RichardP
目的：研究内皮功能和炎症的几种生物标志物是否能在5.9年的随访中改善2型糖尿病的预测，独立于传统的危险因素。方法和程序：共有1,455名来自西方纽约研究的参与者，基线时没有2型糖尿病。偶发2型糖尿病定义为随访访视时空腹血糖超过125 mg/dl或正在接受降糖药物治疗。确定了61名符合病例定义的患者（8/1，000人年），并在性别、种族、研究入组年份和基线空腹血糖（<110或110-125 mg/dl）方面与最多三个对照组进行了个体匹配。生物标志物从冷冻的基线样本中测量。结果：在解释传统危险因素的条件Logistic回归分析中（年龄、糖尿病家族史、吸烟、饮酒状况和BMI），E-选择素与糖尿病患者的年龄呈正相关。（第三与第一三分位数：比值比2.77，95%可信区间（CI）1.13- 6.79，P线性趋势= 0.023）与血清白蛋白呈负相关（第三个三分位数与第一个三分位数：比值比0.36，95%CI 0.14- 0.93，线性趋势P = 0.032）与2型糖尿病发病率的关系。将E选择素、血清白蛋白和白细胞计数添加到仅包括传统风险因素的基本风险因素模型中，显著增加了受试者工作特征曲线下面积（AUC）（0.646 ~ 0.726，P值= 0.04）。讨论：上述结果支持内皮功能障碍和亚临床炎症在2型糖尿病发病机制中的重要作用;此外，他们指出，新的生物标志物可能会改善2型糖尿病的预测，而不仅仅是使用传统的危险因素。
Objective:To examine whether several biomarkers of endothelial function and inflammation improve prediction of type 2 diabetes over 5.9 years of follow‐up, independent of traditional risk factors.Methods and Procedures:A total of 1,455 participants from the Western New York Study, free of type 2 diabetes at baseline, were selected. Incident type 2 diabetes was defined as fasting glucose exceeding 125 mg/dl or on antidiabetic medication at the follow‐up visit. Sixty‐one people who met the case definition (8/1,000 person years) were identified and individually matched with up to three controls on gender, race, year of study enrollment, and baseline fasting glucose (<110 or 110–125 mg/dl). Biomarkers were measured from frozen baseline samples.Results:In conditional logistic regression analyses accounting for traditional risk factors (age, family history of diabetes, smoking, drinking status, and BMI), E‐selectin was positively related (3rd vs. 1st tertile: odds ratio 2.77, 95% confidence interval (CI) 1.13–6.79,Pfor linear trend = 0.023) and serum albumin was inversely related (3rd vs. 1st tertile: odds ratio 0.36, 95% CI 0.14–0.93,Pfor linear trend = 0.032) to type 2 diabetes incidence. The addition of E‐selectin, serum albumin, and leukocyte count to a basic risk factor model including only traditional risk factors significantly increased the area under the receiver operating characteristic curve (AUC) (from 0.646 to 0.726,Pvalue = 0.04).Discussion:These results support the role of endothelial dysfunction and subclinical inflammation as important mechanisms in the etiopathogenesis of type 2 diabetes; moreover, they indicate that novel biomarkers may improve the prediction of type 2 diabetes beyond the use of traditional risk factors alone.