Lipoprotein particles and incident type 2 diabetes in the multi-ethnic study of atherosclerosis.
Lipoprotein particles and incident type 2 diabetes in the multi-ethnic study of atherosclerosis.
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DOI：
10.2337/dc14-0645
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发表时间：
2015-04
期刊：
影响因子：
16.2
通讯作者：
Goff DC Jr
中科院分区：
文献类型：
--
作者：
Mackey RH;Mora S;Bertoni AG;Wassel CL;Carnethon MR;Sibley CT;Goff DC Jr
在动脉粥样硬化的多种族研究（梅萨）中，我们评估了基于脂蛋白的胰岛素抵抗（IR）指数（LP-IR）、IR相关脂蛋白颗粒、平均颗粒大小和脂质的基线水平与2型糖尿病发病率的相关性，独立于混杂因素、葡萄糖、胰岛素和HOMA-IR。在5,314名45-84岁无基线糖尿病或心血管疾病的成年人中，在平均7.7年的随访期间，确定了656例糖尿病患者。通过储存的基线血浆的核磁共振光谱测定脂蛋白颗粒浓度、大小和LP-IR。还根据人种/种族、性别、基线使用降脂药物或激素治疗或血糖分层（<90、90-99和≥100 mg/dL）评价了潜在效应修改。高水平的LP-IR、大VLDL颗粒（VLDL-P）、小LDL颗粒、甘油三酯（TG）和TG/HDL胆固醇（HDL-C）比值以及低水平的大HDL颗粒、小HDL和LDL尺寸以及大VLDL尺寸与调整混杂因素和葡萄糖或胰岛素后的糖尿病发病率显著相关。这些结果在人种/种族、性别和治疗组之间也相似。LP-IR、大VLDL-P、平均VLDL大小、TG和TG/HDL-C比值的相关性相似; LP-IR、大VLDL-P或经HOMA-IR或TG/HDL-C比值和葡萄糖校正的平均VLDL大小的相关性持续存在，但经LP-IR或HOMA-IR或胰岛素校正的TG/HDL-C比值（如果经LP-IR和葡萄糖校正）的相关性不存在。在不同种族的男性和女性中，LP-IR、大VLDL-P、大VLDL大小、TG和TG/HDL-C比值与糖尿病事件相关，与已确定的风险因素、血糖、胰岛素或HOMA-IR以及降脂药物或激素治疗的使用无关。
In the Multi-Ethnic Study of Atherosclerosis (MESA), we evaluated associations of baseline levels of a lipoprotein-based insulin resistance (IR) index (LP-IR), IR-related lipoprotein particles, mean particle sizes, and lipids, with incident type 2 diabetes, independent of confounders, glucose, insulin, and HOMA-IR. Among 5,314 adults aged 45–84 years without baseline diabetes or cardiovascular disease, 656 cases of diabetes were identified during a mean follow-up of 7.7 years. Lipoprotein particle concentrations, size, and LP-IR were determined by nuclear magnetic resonance spectroscopy of stored baseline plasma. Potential effect modification, by race/ethnicity, sex, baseline use of lipid-lowering medications or hormone therapy, or glucose strata (<90, 90–99, and ≥100 mg/dL), was also evaluated. Higher levels of LP-IR, large VLDL particles (VLDL-P), small LDL particles, triglycerides (TG), and TG–to–HDL cholesterol (HDL-C) ratio and lower levels of large HDL particles, smaller HDL and LDL size, and larger VLDL size were significantly associated with incident diabetes adjusted for confounders and glucose or insulin. These also were similar by race/ethnicity, sex, and treatment group. Associations were similar for LP-IR, large VLDL-P, mean VLDL size, TG, and TG–to–HDL-C ratio; they persisted for LP-IR, large VLDL-P, or mean VLDL size adjusted for HOMA-IR or TG–to–HDL-C ratio and glucose but not for the TG–to–HDL-C ratio adjusted for LP-IR or for HOMA-IR or insulin if adjusted for LP-IR and glucose. Among ethnically diverse men and women, LP-IR, large VLDL-P, large VLDL size, TG, and TG–to–HDL-C ratio were associated with incident diabetes independent of established risk factors, glucose, insulin, or HOMA-IR, as well as the use of lipid-lowering medications or hormone therapy.