Metabolic and inflammation variable clusters and prediction of type 2 diabetes - Factor analysis using directly measured insulin sensitivity
Metabolic and inflammation variable clusters and prediction of type 2 diabetes - Factor analysis using directly measured insulin sensitivity
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DOI：
10.2337/diabetes.53.7.1773
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发表时间：
2004-07-01
期刊：
影响因子：
7.7
通讯作者：
Haffner, SM
中科院分区：
文献类型：
--
作者：
Hanley, AJG;Festa, A;Haffner, SM
因子分析是一种多变量相关技术，已被用来深入了解代谢综合征的潜在结构。然而，之前的大多数因素分析仅使用胰岛素敏感性的替代指标。很少包含非传统心血管疾病 (CVD) 危险因素，如纤溶酶原激活剂抑制剂 (PAI)-1、纤维蛋白原和 C 反应蛋白 (CRP)；只有有限的人评估了预测 2 型糖尿病的因素的能力。本研究的目的是利用胰岛素抵抗动脉粥样硬化研究 (IRAS) 中 1,087 名非糖尿病参与者的数据，通过因子分析来调查代谢和炎症变量的聚类，并确定这些聚类与随访时 2 型糖尿病风险的关联。这项研究包括从 40-69 岁非裔美国人、西班牙裔和非西班牙裔白人受试者中频繁采样的静脉葡萄糖耐量测试中直接测量的胰岛素敏感性 (Si) 的信息。对基线（1992-1994）非糖尿病受试者数据的主因子分析确定了三个因素，分别解释了数据集中总方差的 28.4%、7.4% 和 6%。基于大于或等于 0.40 的因子载荷，这些因子被解释为 1) “代谢”因子，其中 BMI、腰围、2 小时血糖、log 甘油三酯和 log PAI-1 为正载荷，log S-i + 1 和 HDL 为负载荷； 2)“炎症”因子，具有BMI、腰围、纤维蛋白原和log CRP的正负荷以及log Si+1的逆负荷； 3)“血压”因素，具有收缩压和舒张压的正负荷。不同种族阶层的结果相似，并且在性别特异性分析中仅存在细微差别。在一项前瞻性分析中，在中位随访期 5.2 年之后，每个因素都是糖尿病的重要预测因素，并且每个因素在包含所有三个因素的多变量模型中仍然显着，尽管这个三因素模型并不比使用糖耐量受损或传统 CVD 危险因素的模型具有显着的预测能力。因子分析确定了一组炎症和代谢综合征变量中的三个潜在因素，胰岛素敏感性对代谢和炎症变量簇都有影响。在多变量分析中，每个因素都显着预测糖尿病。这些发现支持了一个新的假设，即慢性亚临床炎症与胰岛素抵抗有关，并且是代谢综合征的一个组成部分。
Factor analysis, a multivariate correlation technique, has been used to provide insight into the underlying structure of the metabolic syndrome. The majority of previous factor analyses, however, have used only surrogate measures of insulin sensitivity; very few have included nontraditional cardiovascular disease (CVD) risk factors such as plasminogen activator inhibitor (PAI)-1, fibrinogen, and C-reactive protein (CRP); and only a limited number have assessed the ability of factors to predict type 2 diabetes. The objective of this study was to investigate, using factor analysis, the clustering of metabolic and inflammation variables using data from 1,087 nondiabetic participants in the Insulin Resistance Atherosclerosis Study (IRAS) and to determine the association of these clusters with risk of type 2 diabetes at follow-up. This study includes information on directly measured insulin sensitivity (Si) from the frequently sampled intravenous glucose tolerance test among African-American, Hispanic, and non-Hispanic white subjects aged 40-69 years. Principal factor analysis of data from nondiabetic subjects at baseline (1992-1994) identified three factors, which explained 28.4, 7.4, and 6% of the total variance in the dataset, respectively. Based on factor loadings of greater than or equal to 0.40, these factors were interpreted as 1) a "metabolic" factor, with positive loadings of BMI, waist circumference, 2-h glucose, log triglyceride, and log PAI-1 and inverse loadings of log S-i + 1 and HDL; 2) an "inflammation" factor, with positive loadings of BMI, waist circumference, fibrinogen, and log CRP and an inverse loading of log Si + 1; and 3) a "blood pressure" factor, with positive loadings of systolic and diastolic blood pressure. The results were similar within strata of ethnicity, and there were only subtle differences in sex-specific analyses. In a prospective analysis, each of the factors was a significant predictor of diabetes after a median follow-up period of 5.2 years, and each factor remained significant in a multivariate model that included all three factors, although this three-factor model was not significantly more predictive than models using either impaired glucose tolerance or conventional CVD risk factors. Factor analysis identified three underlying factors among a group of inflammation and metabolic syndrome variables, with insulin sensitivity loading on both the metabolic and inflammation variable clusters. Each factor significantly predicted diabetes in multivariate analysis. The findings support the emerging hypothesis that chronic subclinical inflammation is associated with insulin resistance and comprises a component of the metabolic syndrome.