Low-grade systemic inflammation and the development of type 2 diabetes - The atherosclerosis risk in communities study
Low-grade systemic inflammation and the development of type 2 diabetes - The atherosclerosis risk in communities study
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DOI：
10.2337/diabetes.52.7.1799
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发表时间：
2003-07-01
期刊：
影响因子：
7.7
通讯作者：
Heiss, G
中科院分区：
文献类型：
--
作者：
Duncan, BB;Schmidt, MI;Heiss, G
为了检查低度全身炎症与糖尿病的关联及其在亚组之间的异质性，我们设计了一项病例队列研究，代表 10,275 名社区动脉粥样硬化风险研究参与者的 9 年类似经历。对 581 例糖尿病病例和 572 例非糖尿病病例的储存血浆进行了分析物测量。根据年龄、性别、种族、研究中心、父母糖尿病史和高血压进行调整后，炎症标志物第四（相对于第一）四分位数的人患糖尿病的统计显着风险比为唾液酸、类粘蛋白、白细胞介素 6 和 C 反应蛋白，范围为 1.9 至 2.8。在对 BMI、腰臀比、空腹血糖和胰岛素进行额外调整后，只有白细胞介素 6 相关性仍具有统计学显着性（HR = 1.6、1.01-2.7）。排除 GAD 抗体阳性个体对关联的影响微乎其微。基于这四种标志物加上白细胞计数和纤维蛋白原的总体炎症评分可以预测白人而非非裔美国人的糖尿病（交互作用 P = 0.005）以及不吸烟者但不能预测吸烟者的糖尿病（交互作用 P = 0.13）。与得分极值的白人非吸烟者相比，完全调整后的风险比为 3.7（线性趋势 P = 0.008）。总之，低度炎症预示着 2 型糖尿病的发生。吸烟者和非裔美国人中不存在这种关联。
To examine the association of low-grade systemic inflammation with diabetes, as well as its heterogeneity across subgroups, we designed a case-cohort study representing the similar to9-year experience of 10,275 Atherosclerosis Risk in Communities Study participants. Analytes were measured on stored plasma of 581 incident cases of diabetes and 572 noncases. Statistically significant hazard ratios of developing diabetes for those in the fourth (versus first) quartile of inflammation markers, adjusted for age, sex, ethnicity, study center, parental history of diabetes, and hypertension, ranged from 1.9 to 2.8 for sialic acid, orosomucoid, interleukin-6, and C-reactive protein. After additional adjustment for BMI, waist-to-hip ratio, and fasting glucose and insulin, only the interleukin-6 association remained statistically significant (HR = 1.6, 1.01-2.7). Exclusion of GAD antibody-positive individuals changed associations minimally. An overall inflammation score based on these four markers plus white cell count and fibrinogen predicted diabetes in whites but not African Americans (interaction P = 0.005) and in nonsmokers but not smokers (interaction P = 0.13). The fully adjusted hazard ratio comparing white nonsmokers with score extremes was 3.7 (P for linear trend = 0.008). In conclusion, a low-grade inflammation predicts incident type 2 diabetes. The association is absent in smokers and African-Americans.