Adiponectin levels predict prediabetes risk: the Pathobiology of Prediabetes in A Biracial Cohort (POP-ABC) study.
Adiponectin levels predict prediabetes risk: the Pathobiology of Prediabetes in A Biracial Cohort (POP-ABC) study.
复制标题
DOI：
10.1136/bmjdrc-2016-000194
复制
发表时间：
2016
影响因子：
4.1
通讯作者：
Dagogo-Jack S
中科院分区：
文献类型：
--
作者：
Jiang Y;Owei I;Wan J;Ebenibo S;Dagogo-Jack S
脂联素水平存在种族差异，并且与 2 型糖尿病 (T2DM) 的风险呈负相关。然而，脂联素与不同人群中糖尿病前期风险的关系尚未得到充分研究。在这里，我们评估了纵向双种族队列中与糖尿病前期事件相关的基线脂联素水平。一项双种族队列研究中糖尿病前期的病理学对患有 T2DM 的父母的非糖尿病后代进行了糖尿病前期的发生跟踪，糖尿病前期定义为空腹血糖受损和/或糖耐量受损。入组和随访期间的评估包括75克口服葡萄糖耐量试验、人体测量、生物化学（包括空腹胰岛素和脂联素水平）、胰岛素敏感性和胰岛素分泌。使用逻辑回归来评估脂联素对进展为糖尿病前期的风险的贡献。在 333 名研究参与者中（平均 (SD) 年龄 44.2 (10.6) 岁），151 名 (45.3%) 为白人，182 名 (54.8%) 为黑人。在大约 5.5（平均 2.62）年的随访期间，110 名参与者（33%）进展为糖尿病前期（N=100）或 T2DM（N=10），223 名参与者（67%）为非进展者。平均队列脂联素水平为 9.41+5.30 μg/mL（范围 3.1–45.8 μg/mL）；女性的值高于男性（10.3+5.67 μg/mL vs 7.27+3.41 μg/mL，p<0.0001），白人后代高于黑人后代（10.7+5.44 μg/mL vs 8.34+4.95 μg/mL，p<0.0001）。脂联素水平与肥胖和血糖呈负相关，与胰岛素敏感性和高密度脂蛋白胆固醇水平呈正相关。基线脂联素强烈预测糖尿病前期的发生：基线脂联素每升高 1 个 SD（约 5 μg/mL），糖尿病前期的 HR 为 0.48（95% CI 0.27 至 0.86，p=0.013）。在父母有 T2DM 病史的健康白人和黑人成年人中，脂联素水平是发生糖尿病前期的一个强有力的风险标志。因此，众所周知，脂联素与糖尿病风险的关联在发病机制的早期阶段，即从血糖正常到糖尿病前期的转变过程中就很明显。
Adiponectin levels display ethnic disparities, and are inversely associated with the risk of type 2 diabetes (T2DM). However, the association of adiponectin with prediabetes risk in diverse populations has not been well-studied. Here, we assessed baseline adiponectin levels in relation to incident prediabetes in a longitudinal biracial cohort. The Pathobiology of Prediabetes in A Biracial Cohort study followed non-diabetic offspring of parents with T2DM for the occurrence of prediabetes, defined as impaired fasting glucose and/or impaired glucose tolerance. Assessments at enrollment and during follow-up included a 75 g oral glucose tolerance test, anthropometry, biochemistries (including fasting insulin and adiponectin levels), insulin sensitivity and insulin secretion. Logistic regression was used to evaluate the contribution of adiponectin to risk of progression to prediabetes. Among the 333 study participants (mean (SD) age 44.2 (10.6) year), 151(45.3%) were white and 182 (54.8%) were black. During approximately 5.5 (mean 2.62) years of follow-up, 110 participants (33%) progressed to prediabetes (N=100) or T2DM (N=10), and 223 participants (67%) were non-progressors. The mean cohort adiponectin level was 9.41+5.30 μg/mL (range 3.1–45.8 μg/mL); values were higher in women than men (10.3+5.67 μg/mL vs 7.27+3.41 μg/mL, p<0.0001) and in white than black offspring (10.7+5.44 μg/mL vs 8.34+4.95 μg/mL, p<0.0001). Adiponectin levels correlated inversely with adiposity and glycemia, and positively with insulin sensitivity and high-density lipoprotein cholesterol levels. Baseline adiponectin strongly predicted incident prediabetes: the HR for prediabetes per 1 SD (approximately 5 μg/mL) higher baseline adiponectin was 0.48 (95% CI 0.27 to 0.86, p=0.013). Among healthy white and black adults with parental history of T2DM, adiponectin level is a powerful risk marker of incident prediabetes. Thus, the well-known association of adiponectin with diabetes risk is evident at a much earlier stage in pathogenesis, during transition from normoglycemia to prediabetes.