美国黑人和白人晚期糖基化终产物和糖尿病的可溶性受体：REGARDS研究

Q2 Medicine

Obesity Medicine Pub Date : 2025-09-01 DOI:10.1016/j.obmed.2025.100647

Brittney J. Palermo , Katherine S. Wilkinson , Timothy B. Plante , Suzanne E. Judd , Debora Kamin Mukaz , D. Leann Long , Nels C. Olson , Melissa J. Smith , Mary Cushman

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引用次数: 0

摘要

背景：糖尿病是美国发病率和死亡率的主要原因，对黑人的影响大于白人。晚期糖基化终产物的可溶性受体（sRAGE）阻止诱导炎症的信号传导，并参与糖尿病的发病机制。该分析调查了低sRAGE是否与糖尿病风险相关，以及sRAGE是否介导了糖尿病的种族差异。方法对30239名年龄≥45岁的黑人和白人进行卒中前瞻性队列研究，并进行基线和随访检查。我们研究了4400名参与者的亚队列，随访9.5年，对糖尿病进行分类，并对更大的队列进行调查加权分析。在3400名有糖尿病风险的患者中测量了基线sRAGE；修正泊松回归用sRAGE估计相对危险度（RR）。反向优势加权中介分析检验了sRAGE对糖尿病种族差异的贡献。结果：10%的白人和18%的黑人参与者经历了偶发性糖尿病。与第四个四分位数相比，低四分位数的sRAGE中糖尿病的RR升高。调整糖尿病危险因素后，与最高四分位数相比，最低四分位数的RR为1.32 (95% CI 0.97-1.79)（四分位数的p趋势为0.06）。sRAGE并没有调节糖尿病的种族差异。结论：在美国黑人和白人中，低sRAGE与患糖尿病的风险增加有关；协变量调整后，相关性减弱并变得不显著。sRAGE可以作为糖尿病风险的标记物，但由于较小的非显著相关性，并且没有确定sRAGE的关联中介，因此临床应用不太可能。

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Soluble receptor for advanced glycation end products and diabetes in Black and White Americans: the REGARDS study

Background

Diabetes is a leading cause of morbidity and mortality in the United States, affecting Black more than White adults. The soluble receptor for advanced glycation end products (sRAGE) prevents signaling that induces inflammation and is implicated in diabetes pathogenesis. This analysis investigated if low sRAGE is associated with diabetes risk, and if sRAGE mediates the racial disparity in diabetes.

Methods

The REasons for Geographic and Racial Differences in Stroke prospective cohort included 30,239 Black and White adults aged ≥45 with baseline and follow up exam. We studied a 4400 participant sub-cohort with 9.5-year follow-up to classify diabetes, with analyses being survey weighted to the larger cohort. Baseline sRAGE was measured in 3400 at risk for diabetes; modified Poisson regression estimated relative risk (RR) by sRAGE. Inverse odds weighting mediation analysis examined the contribution of sRAGE to the racial disparity in diabetes.

Results

Ten percent of White and 18 % of Black participants experienced incident diabetes. The RR of diabetes was elevated in lower quartiles of sRAGE compared to the fourth quartile. With diabetes risk factor adjustment, the RR was 1.32 (95 % CI 0.97–1.79) in the lowest compared to the highest quartile (p-trend across quartiles 0.06). sRAGE did not mediate any of the racial disparity in diabetes.

Conclusions

Among Black and White Americans, low sRAGE was associated with increased risk of developing diabetes; associations attenuated and became non-significant with covariate adjustment. sRAGE may serve as a marker for diabetes risk, but clinical utility is unlikely given small non-significant associations, and no identified mediation of the association by sRAGE.

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来源期刊

Obesity Medicine Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.50

自引率

0.00%

发文量

审稿时长

40 days

期刊介绍： The official journal of the Shanghai Diabetes Institute Obesity is a disease of increasing global prevalence with serious effects on both the individual and society. Obesity Medicine focusses on health and disease, relating to the very broad spectrum of research in and impacting on humans. It is an interdisciplinary journal that addresses mechanisms of disease, epidemiology and co-morbidities. Obesity Medicine encompasses medical, societal, socioeconomic as well as preventive aspects of obesity and is aimed at researchers, practitioners and educators alike.