目的:研究印度促炎标志物与糖尿病发病的关系。
方法:我们在CARRS(南亚代谢风险降低中心)队列中进行了嵌套病例对照研究。在基线的5739名无糖尿病个体中,216名糖尿病患者和432名年龄-,纳入了2年随访时性别和城市匹配的对照.我们测量了高敏C反应蛋白(hsCRP),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),单核细胞趋化蛋白-1(MCP-1),脂联素,储存的基线血样中的瘦素和胎球蛋白A。我们进行了多因素条件逻辑回归,以估计炎症标志物(以四分位数表示)与糖尿病的相关性。协变量为基线空腹血糖(FPG)和血脂,体重指数(BMI),糖尿病家族史,吸烟和饮酒。
结果:基线hsCRP和TNF-α较高,IL-6和脂联素在病例中低于controls.在多元条件逻辑回归模型中,校正基线FPG和MCP-1的四分位数-4(OR:2.55[95%CI:1.06,6.16])与糖尿病呈正相关。调整家族史后,这些关联并未保留。校正所有因素后,高水平(四分位数-4)的IL-6与糖尿病呈负相关(OR:0.18[95%CI:0.06,0.55])。
结论:较高的TNF-α和MCP-1水平和较低的IL-6水平与较高的患糖尿病风险相关。更好地理解和解决这些生物标志物的潜在方法,尤其是关于家族史,需要解决南亚人的糖尿病。
OBJECTIVE: To study the association of pro-inflammatory markers with incident diabetes in India.
METHODS: We did a nested
case-control study within the CARRS (Centre for Ardiometabolic Risk Reduction in South Asia) cohort. Of the 5739 diabetes-free individuals at the baseline, 216 participants with incident diabetes and 432 age-, gender- and city-matched controls at 2-year follow-up were included. We measured high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 ( MCP-1), adiponectin, leptin and fetuin-A in the stored baseline blood samples. We did multivariate conditional logistic regression to estimate association of inflammatory markers (as quartiles) and incident diabetes. Covariates were baseline fasting plasma glucose (FPG) and lipids, body mass index (BMI), family history of diabetes, smoking and alcohol use.
RESULTS: Baseline hsCRP and TNF-α were higher, and IL-6 and adiponectin were lower among cases vs. controls. In multivariate conditional logistic regression models, only quartile-3 (odds ratio [OR]: 2.96 [95% CI:1.39, 6.30]) and quartile-4 (OR: 2.58 [95% CI: 1.15, 5.79]) of TNF-α and quartile-4 of MCP-1 (OR: 2.55 [95% CI: 1.06, 6.16]) were positively associated with diabetes after adjusting for baseline FPG and BMI. These associations did not remain after adjusting for family history. High level (quartile-4) of IL-6 was negatively associated with diabetes after adjusting for all factors (OR: 0.18 [95% CI: 0.06, 0.55]).
CONCLUSIONS: Higher TNF-α and MCP-1 levels and lower IL-6 were associated with higher risk of developing diabetes. Better understanding and potential methods of addressing these biomarkers, especially in relation to family history, are needed to address diabetes in South Asians.