Serum Levels of Apolipoproteins and Incident Type 2 Diabetes: A Prospective Cohort Study
Serum Levels of Apolipoproteins and Incident Type 2 Diabetes: A Prospective Cohort Study
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DOI：
10.2337/dc16-1295
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发表时间：
2017-03-01
期刊：
影响因子：
16.2
通讯作者：
Dehghan, Abbas
中科院分区：
文献类型：
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作者：
Brahimaj, Adela;Ligthart, Symen;Dehghan, Abbas
目的我们旨在调查各种载脂蛋白的血清水平对 2 型糖尿病 (T2D) 风险的作用。研究设计和方法我们使用来自鹿特丹前瞻性研究的 971 名个体的数据。我们研究了 HDL 胆固醇 (HDL-C)、apoA1、apoCIII、apoD 和 apoE 以及载脂蛋白与 apoA1 的比率与 T2D 风险之间的关系。所有载脂蛋白、比率和 HDL-C 水平均经过自然对数转换以达到正态分布。首先，通过线性回归研究了它们与空腹血糖和胰岛素的横截面关联。其次，使用 Cox 比例风险模型来检查载脂蛋白是否可以预测基线时无糖尿病的个体患 T2D 的风险。我们还通过从第一步开始计算载脂蛋白评分，然后用它进行 Cox 回归来联合研究载脂蛋白。 结果在中位随访 13.5 年期间，110 名个体出现糖尿病。调整年龄、性别、BMI、父母糖尿病史、高血压、饮酒、吸烟、流行的心血管疾病和血清降脂剂后，HDL-C（每 1 SD 自然对数转换风险比 0.74 [95% CI 0.57, 0.97]、apoCIII (1.65 [1.42, 1.91])、apoE (1.36 [1.18, 1.55]）、apoCIII 与 apoA1 比率（1.72 [1.51, 1.95]）、apoE 与 apoA1 比率（1.28 [1.13, 1.45]）和载脂蛋白评分（1.60 [1.39, 1.83]）仍然显着。 1.96]) 和 apoCIII-与 apoA1 比率 (1.56 [1.04, 2.36]) 在最后一个模型中对甘油三酯的调整后仍然存在。结论血清 apoCIII 水平以及 apoCIII-与 apoA1 比率与 T2D 事件相关，且与已知的危险因素无关，并且强于 HDL-C 水平。
OBJECTIVEWe aimed to investigate the role of serumlevels of various apolipoproteins on the risk for type 2 diabetes (T2D).RESEARCH DESIGN AND METHODSWe used data from 971 individuals from the prospective population-based Rotterdam Study. We studied the association of HDL cholesterol (HDL-C), apoA1, apoCIII, apoD, and apoE as well as the ratios of apolipoproteins with apoA1 with the risk of T2D. All apolipoproteins, ratios, and HDL-C levels were naturally log-transformed to reach normal distribution. First, their cross-sectional associations with fasting glucose and insulin were investigated by using linear regression. Second, Cox proportional hazard models were used to examine whether apolipoproteins predict the risk for T2D among individuals free of diabetes at baseline. We also studied the apolipoproteins jointly by calculating the apolipoproteinic score from the first step and then performing Cox regression with it.RESULTSDuring a median follow-up of 13.5 years, diabetes developed in 110 individuals. After adjustment for age, sex, BMI, parental history of diabetes, hypertension, alcohol use, smoking, prevalent cardiovascular disease, and serum lipid-reducing agents, HDL-C (per 1 SD naturally log-transformed hazard ratio 0.74 [95% CI 0.57, 0.97], apoCIII (1.65 [1.42, 1.91]), apoE (1.36 [1.18, 1.55]), apoCIII-to-apoA1 ratio (1.72 [1.51, 1.95]), apoE-to-apoA1 ratio (1.28 [1.13, 1.45]), and apolipoproteinic score (1.60 [1.39, 1.83]) remained significant. Only apoCIII (1.42 [1.03, 1.96]) and apoCIII-to-apoA1 ratio (1.56 [1.04, 2.36]) survived the adjustment for triglycerides in the last model.CONCLUSIONSSerum apoCIII levels as well as apoCIII-to-apoA1 ratio are associatedwith incident T2D. They are associated independent of known risk factors and stronger than HDL-C levels.