Comparing the inflammatory profiles for incidence of diabetes mellitus and cardiovascular diseases: a prospective study exploring the ‘common soil’ hypothesis

Autor: Linda S B Johnson, Gunnar Engström, Kaijun Niu, Iram Faqir Muhammad, Yan Borné, Xue Bao, Margaretha Persson
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Time Factors
Proportional hazards models
Endocrinology
Diabetes and Metabolism
Inflammatory markers
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Gastroenterology
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Diet and cancer
Insulin resistance
Diabetes mellitus
Risk Factors
Internal medicine
Medicine
Humans
Neutrophil to lymphocyte ratio
Prospective cohort study
Original Investigation
Inflammation
Sweden
business.industry
Proportional hazards model
Incidence
Survival analysis
Middle Aged
medicine.disease
Prognosis
Cardiovascular diseases
lcsh:RC666-701
Competing risks analysis
Cohort
Female
Inflammation Mediators
Cardiology and Cardiovascular Medicine
business
Cohort study
Biomarkers
Zdroj: Cardiovascular Diabetology
Cardiovascular Diabetology, Vol 17, Iss 1, Pp 1-11 (2018)
ISSN: 1475-2840
Popis: Background Chronic low-grade inflammation and associated insulin resistance and metabolic abnormalities have been proposed as ‘common soil’ for diabetes mellitus (DM) and cardiovascular disease (CVD). This paper aimed to investigate the inflammatory profiles of DM and CVD and to distinguish their shared and specific markers. Methods Based on the Malmö Diet and Cancer cohort, total and differential leukocyte counts were measured in 25,969 participants without previous DM or CVD and were studied in relation to incident DM (mean follow-up 17.4 ± 5.58 years) and incident CVD (i.e., coronary events, including fatal and nonfatal myocardial infarction, or stroke); mean follow-up 17.7 ± 5.46 years, using multivariable Cox regression models. Furthermore, plasma concentrations of another seven inflammatory markers were examined in relation to incident DM and incident CVD in a sub-cohort of 4658 participants. The associations of each inflammatory marker with incident DM versus incident CVD were compared using the Lunn–McNeil competing risks approach. In sensitivity analyses, those who developed both DM and CVD during follow-up were excluded. Results After adjustment for conventional risk factors, total and differential leukocyte counts, orosomucoid, and C-reactive protein were associated with an increased risk of both DM and CVD. Neutrophil to lymphocyte ratio, ceruloplasmin, alpha1-antitrypsin and soluble urokinase plasminogen activator receptor predicted increased risk of CVD but not DM, while haptoglobin and complement C3 showed the opposite pattern. In competing risks analyses, lymphocyte count and complement C3 had stronger associations with risk of DM than with risk of CVD (p for equal associations = 0.020 and 0.006). The reverse was true for neutrophil to lymphocyte ratio (p for equal associations = 0.025). Results were consistent in sensitivity analyses. Conclusions The results indicated substantial similarities in the inflammatory profiles associated with DM and CVD. However, there are also significant differences. These findings may help discriminate between individuals at elevated risk of DM and those at elevated risk of CVD, which is a prerequisite for targeted therapies. Electronic supplementary material The online version of this article (10.1186/s12933-018-0733-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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