Diabetes Care:血清淀粉样蛋白A或预测2型糖尿病

　　德国研究者一项研究表明，急性期血清淀粉样蛋白A（A-SAA）和高敏C反应蛋白（hs-CRP）对2型糖尿病有相似的预测关系。该研究12月13日在线发表于《糖尿病护理》（Diabetes Care）杂志。

　　为了研究S-SAA水平是否在2型糖尿病发生前已升高且独立于其他危险因素包括葡萄糖代谢参数，研究者在奥格斯堡地区基于人群的健康协作研究（KORA）S4试验中，在包含口服糖耐量检测的7年随访期间，监测了836名初始非糖尿病且无临床明显炎症的受试者的A-SAA浓度。

　　结果表明，A-SAA浓度与2型糖尿病的发生显著相关，校正年龄和性别后A-SAA升高1个标准差的2型糖尿病风险比（OR）为1.28（95%CI为1.08~1.53，P=0.005），较年轻的受试者尤甚。校正糖代谢参数后上述相关性减弱，OR为1.16，P=0.15。对hs-CRP的分析结果相似，OR分别为1.39（P=0.0006）和1.13（P=0.34）。不过，即使校正糖代谢参数，随访的A-SAA浓度仍与2小时血糖水平显著相关（P=0.008）。

与2型糖尿病相关的拓展阅读：

• 血清淀粉样蛋白A或预测2型糖尿病
• Diabetes Care:有效的服药依从性自我报告利于2型糖尿病管理
• BMC MED：磺脲类和二甲双胍联用或降2型糖尿病患者情感障碍风险
• Diabetes Care:血清铁蛋白与2型糖尿病患病率相关
• NEJM: 阿利吉仑治疗2型糖尿病的临床试验：心肾终点
更多信息请点击：有关2型糖尿病更多资讯

Acute-Phase Serum Amyloid A Protein and Its Implication in the Development of Type 2 Diabetes in the KORA S4/F4 Study

OBJECTIVE 

We sought to investigate whether elevated levels of acute-phase serum amyloid A (A-SAA) protein precede the onset of type 2 diabetes independently of other risk factors, including parameters of glucose metabolism.

RESEARCH DESIGN AND METHODS 

Within the population-based Cooperative Health Research in the Region of Augsburg (KORA) S4 study, we measured A-SAA concentrations in 836 initially nondiabetic subjects (55–74 years of age) without clinically overt inflammation who participated in a 7-year follow-up examination including an oral glucose tolerance test.

RESULTS 

A-SAA concentrations were significantly associated with incident type 2 diabetes (odds ratio [OR] for a one-SD increase of A-SAA adjusted for age and sex = 1.28 [95% CI 1.08–1.53], P = 0.005), particularly in younger subjects (P value for interaction = 0.047). The association attenuated when adjusting for parameters of glucose metabolism (fasting glucose, fasting insulin, HbA1c, and 2-h glucose; OR 1.16 [0.95–1.42], P = 0.15). Similar analyses for high-sensitive C-reactive protein (hs-CRP) yielded the following ORs: 1.39 (1.10–1.68, P = 0.0006) and 1.13 (0.88–1.45, P = 0.34), respectively. In contrast, A-SAA concentrations were significantly associated with 2-h glucose levels at follow-up even after adjustment for parameters of glucose metabolism (P = 0.008, n = 803).

CONCLUSIONS 

Our findings indicate similarly strong prospective associations with type 2 diabetes for A-SAA and hs-CRP and suggest a potential causal link via postchallenge hyperglycemia.