Sex differences in associations of metabolic inflammation and insulin resistance with incident type 2 diabetes mellitus: a retrospective cohort of adults with annual health examinations.
Yang Li, Xiaotong Guo, Jianli Ge, Qingqing Li, Xin Chen, Yingqian Zhu, Huixiao Yuan, Shasha Geng, Yue Liu
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引用次数: 0
Abstract
Background and aims: Cardio-kidney-metabolic diseases are major causes of premature death worldwide, with type 2 diabetes mellitus (T2DM) playing a critical role. Inflammation and insulin resistance have been implicated in the pathogenesis of T2DM. This study aimed to investigate the sex-specific associations of metabolic inflammation and insulin resistance with incident T2DM to support personalized prevention and management strategies.
Methods: A retrospective cohort was used to analyse annual health examination data from the general practice department of a general hospital in Shanghai between 2021 and 2023. After excluding participants diagnosed with T2DM, cardiovascular disease or chronic kidney disease at baseline, 1214 adults were followed up for two years. Cox proportional hazards and logistic regression models were used to assess the associations of triglyceride-glucose body mass index (TyG-BMI), the lymphocyte/high-density lipoprotein cholesterol ratio (LHR), the monocyte/high-density lipoprotein cholesterol ratio (MHR), and the neutrophil/high-density lipoprotein cholesterol ratio (NHR) with incident T2DM.
Results: In the total population, TyG-BMI (all HR/OR > 1, P < 0.05), LHR, MHR and NHR were significantly and positively associated with incident T2DM. TyG-BMI was significantly associated with incident T2DM in men (both HR/OR > 1, P < 0.05), whereas LHR, MHR and NHR were strongly associated with incident T2DM in women (all HR/OR > 1, P < 0.05). The interaction effect between LHR and sex was statistically significant.
Conclusion: Sex differences play an important role in incident T2DM. Men should be aware of weight control to avoid obesity-related insulin resistance, whereas women should monitor metabolic inflammation indicators such as LHR for early detection and intervention of their T2DM risk.
背景和目的：心肾代谢性疾病是世界范围内过早死亡的主要原因，其中2型糖尿病（T2DM）起着关键作用。炎症和胰岛素抵抗与T2DM的发病机制有关。本研究旨在探讨代谢性炎症和胰岛素抵抗与T2DM事件的性别特异性关联，以支持个性化的预防和管理策略。方法：采用回顾性队列法分析上海市某综合医院2021 - 2023年全科年度体检资料。在排除T2DM、心血管疾病或慢性肾脏疾病的参与者后，1214名成年人进行了为期两年的随访。采用Cox比例风险和logistic回归模型评估甘油三酯-葡萄糖体重指数（TyG-BMI）、淋巴细胞/高密度脂蛋白胆固醇比率（LHR）、单核细胞/高密度脂蛋白胆固醇比率（MHR）和中性粒细胞/高密度脂蛋白胆固醇比率（NHR）与T2DM发病的关系。结果：在人群中，TyG-BMI（所有HR/OR > 1, P 1, P 1， P）在T2DM发病中起重要作用。男性应注意控制体重，以避免肥胖相关的胰岛素抵抗，而女性应监测代谢炎症指标，如LHR，以早期发现和干预其T2DM风险。
期刊介绍：
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds.
Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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