Diabetes Care ( IF 16.2 ) Pub Date : 2017-08-10 , DOI: 10.2337/dc17-0201 Barbara Kollerits 1 , Claudia Lamina 1 , Cornelia Huth 2, 3 , Pedro Marques-Vidal 4 , Stefan Kiechl 5 , Ilkka Seppälä 6, 7 , Jackie Cooper 8 , Steven C Hunt 9, 10 , Christa Meisinger 2, 3 , Christian Herder 3, 11 , Ludmilla Kedenko 12 , Johann Willeit 5 , Barbara Thorand 2, 3 , Doreen Dähnhardt 1 , Doris Stöckl 2, 3 , Karin Willeit 5 , Michael Roden 3, 11, 13 , Wolfgang Rathmann 3, 14 , Bernhard Paulweber 12 , Annette Peters 2, 3, 15 , Mika Kähönen 16, 17 , Terho Lehtimäki 6, 7 , Olli T Raitakari 18, 19 , Steve E Humphries 8 , Peter Vollenweider 4 , Hans Dieplinger 1, 20 , Florian Kronenberg 21
OBJECTIVE The human vitamin E–binding glycoprotein afamin is primarily expressed in the liver and has been associated with prevalent and incident metabolic syndrome. These data were in line with observations in transgenic mice. We thus investigated whether afamin concentrations are associated with prediabetes, type 2 diabetes, and insulin resistance (IR).
RESEARCH DESIGN AND METHODS Individual-level baseline (n = 20,136) and follow-up data (n = 14,017) of eight prospective cohort studies were investigated. Study-level data were combined using random-effects meta-analyses. Main outcomes were prevalent and incident type 2 diabetes, prediabetes, and IR. Discrimination and reclassification of participants was analyzed for incident type 2 diabetes.
RESULTS Mean afamin concentrations between studies ranged from 61 to 73 mg/L. The eight studies included 1,398 prevalent and 585 incident cases of type 2 diabetes. Each increase of afamin by 10 mg/L was associated with prevalent type 2 diabetes (odds ratio [OR] 1.19 [95% CI 1.12–1.26], P = 5.96 × 10−8). Afamin was positively associated with IR assessed by HOMA-IR (β 0.110 [95% CI 0.089–0.132], P = 1.37 × 10−23). Most importantly, afamin measured at baseline was an independent predictor for 585 incident cases of type 2 diabetes (OR 1.30 [95% CI 1.23–1.38], P = 3.53 × 10−19) and showed a significant and valuable gain in risk classification accuracy when added to this extended adjustment model.
CONCLUSIONS This pooled analysis in >20,000 individuals showed that afamin is strongly associated with IR, prevalence, and incidence of type 2 diabetes independent of major metabolic risk factors or parameters. Afamin might be a promising novel marker for the identification of individuals at high risk for the development of type 2 diabetes.
中文翻译：
Afamin 的血浆浓度与流行和事件 2 型糖尿病有关：超过 20,000 人的汇总分析
目的人类维生素 E 结合糖蛋白 afamin 主要在肝脏中表达，并与流行和新发的代谢综合征有关。这些数据与转基因小鼠的观察结果一致。因此，我们调查了 afamin 浓度是否与前驱糖尿病、2 型糖尿病和胰岛素抵抗 (IR) 相关。
研究设计和方法对八项前瞻性队列研究的个人水平基线（n = 20,136）和随访数据（n = 14,017）进行了调查。使用随机效应荟萃分析合并研究级数据。主要结局是流行和发病的 2 型糖尿病、前驱糖尿病和 IR。对参与者的歧视和重新分类进行了 2 型糖尿病事件的分析。
结果研究之间的平均 afamin 浓度范围为 61 至 73 mg/L。这八项研究包括 1,398 例流行和 585 例 2 型糖尿病病例。afamin 每增加 10 mg/L 与流行的 2 型糖尿病相关（优势比 [OR] 1.19 [95% CI 1.12–1.26]，P = 5.96 × 10 -8）。Afamin 与 HOMA-IR 评估的 IR 呈正相关（β 0.110 [95% CI 0.089–0.132]，P = 1.37 × 10 -23）。最重要的是，基线时测量的 afamin 是 585 例 2 型糖尿病事件的独立预测因子（OR 1.30 [95% CI 1.23–1.38]，P = 3.53 × 10 -19) 并在添加到此扩展调整模型时显示出显着且有价值的风险分类准确性增益。
结论这项对超过 20,000 名个体的汇总分析表明，afamin 与 IR、患病率和 2 型糖尿病的发病率密切相关，与主要代谢危险因素或参数无关。Afamin 可能是一种很有前途的新型标记物，可用于识别 2 型糖尿病高危人群。
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