最近诊断为2型糖尿病个体的YKL-40、心血管事件和死亡率：一项丹麦队列研究

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-01-01 DOI:10.1016/j.diabres.2024.111970

Alisa D. Kjaergaard , Allan Vaag , Verena H. Jensen , Michael H. Olsen , Kurt Højlund , Peter Vestergaard , Torben Hansen , Reimar W. Thomsen , Niels Jessen

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引用次数: 0

摘要

目的：我们研究了炎症生物标志物YKL-40与2型糖尿病患者心血管事件（CVE）和死亡率的关系：我们对11346名最近被诊断为2型糖尿病的患者进行了长达14年的随访。将基线 YKL-40 水平（9010 人测定）分为百分位数（0-33%、34-66%、67-90% 和 91-100%）并进行连续分析（每 1 SD 对数增量），同时与 CRP（9644 人测定）进行比较。Cox 回归评估了与心房颤动（AF）、缺血性中风（IS）、静脉血栓栓塞（VTE）、心肌梗死（MI）、心力衰竭（HF）、外周动脉疾病（PAD）以及全因、心血管和癌症死亡率的关系：最高（91-100%）与最低（0-33%）YKL-40 百分位数类别的调整 HRs（95% CIs）分别为：房颤 1.31（1.04-1.66），IS 1.43（0.98-2.07），VTE 1.07（0.65-1.76），MI 0.88（0.52-1.48）、HF 1.66（1.19-2.31）、PAD 1.66（1.12-2.48）、全因死亡率 2.18（1.85-2.56）、心血管死亡率 1.64（1.07-2.50）、癌症死亡率 2.73（2.05-3.63）。YKL-40和CRP水平每增加1 SD对数，CVE风险同样增加，其中CRP对心肌梗死和心血管死亡率的影响更大：结论：YKL-40是大多数CVE的预后生物标志物，对全因死亡率而言更是如此，主要由癌症相关原因导致。

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YKL-40, cardiovascular events, and mortality in individuals recently diagnosed with type 2 diabetes: A Danish cohort study

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YKL-40, cardiovascular events, and mortality in individuals recently diagnosed with type 2 diabetes: A Danish cohort study

Aims

We investigated the association of the inflammatory biomarker YKL-40 with cardiovascular events (CVEs) and mortality in individuals with type 2 diabetes.

Methods

We followed 11,346 individuals recently diagnosed with type 2 diabetes for up to 14 years. Baseline YKL-40 levels (measured in 9,010 individuals) were grouped into percentiles (0–33 %, 34–66 %, 67–90 %, and 91–100 %) and analyzed continuously (per 1 SD log increment), with comparisons to CRP (measured in 9,644 individuals). Cox regression assessed associations with atrial fibrillation (AF), ischemic stroke (IS), venous thromboembolism (VTE), myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), and all-cause, cardiovascular, and cancer mortality.

Results

Adjusted HRs (95% CIs) for the highest (91–100%) versus the lowest (0–33%) YKL-40 percentile category were 1.31 (1.04–1.66) for AF, 1.43 (0.98–2.07) for IS, 1.07 (0.65–1.76) VTE, 0.88 (0.52–1.48) for MI, 1.66 (1.19–2.31) for HF, 1.66 (1.12–2.48) for PAD, and 2.18 (1.85–2.56) for all-cause, 1.64 (1.07–2.50) for cardiovascular, and 2.73 (2.05–3.63) for cancer mortality. Each 1 SD log increase in YKL-40 and CRP levels similarly increased CVE risks, with CRP being superior for MI and cardiovascular mortality.

Conclusions

YKL-40 is a prognostic biomarker for most CVEs, and even more so for all-cause mortality, primarily driven by cancer-related causes.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.