期刊
DIABETES CARE
卷 45, 期 3, 页码 701-709出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc21-1609
关键词
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资金
- Research Grants Council [T12-402/13N, R4012-18]
- Chinese University of Hong Kong
- Chinese University of Hong Kong-Shanghai Jiao Tong University Joint Research Fund
- Croucher Foundation
- Chinese University of Hong Kong Global Scholarship Programme for Research Excellence
- Internationalization Faculty Mobility Schemes (Outbound Research Mobility Scheme) from the Office of Academic Links, Chinese University of Hong Kong
- Dragon Culture PhD Scholarships for Medical Studies
- Faculty Postdoctoral Fellowship Scheme, Chinese University of Hong Kong
- JDRF (U.S.)
- JDRF (Australia) CRN
This study found that shorter leukocyte telomere length is associated with an increased risk of glycemic progression in patients with type 2 diabetes. Shorter telomere length is independently associated with higher glycemic exposure during follow-up and a greater risk of diabetes progression. The findings suggest that telomere length may serve as a useful biomarker for monitoring glycemic progression in individuals with type 2 diabetes.
OBJECTIVE Several studies support associations between relative leukocyte telomere length (rLTL), a biomarker of biological aging and type 2 diabetes. This study investigates the relationship between rLTL and the risk of glycemic progression in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS In this cohort study, consecutive Chinese patients with type 2 diabetes (N = 5,506) from the Hong Kong Diabetes Register with stored baseline DNA and available follow-up data were studied. rLTL was measured using quantitative PCR. Glycemic progression was defined as the new need for exogenous insulin. RESULTS The mean (SD) age of the 5,349 subjects was 57.0 (13.3) years, and mean (SD) follow-up was 8.8 (5.4) years. Baseline rLTL was significantly shorter in the 1,803 subjects who progressed to insulin requirement compared with the remaining subjects (4.43 1.16 vs. 4.69 +/- 1.20). Shorter rLTL was associated with a higher risk of glycemic progression (hazard ratio [95% CI] for each unit decrease [to similar to 0.2 kilobases]: 1.10 [1.06-1.14]), which remained significant after adjusting for confounders. Baseline rLTL was independently associated with glycemic exposure during follow-up (beta = -0.05 [-0.06 to -0.04]). Each 1-kilobase decrease in absolute LTL was on average associated with a 1.69-fold higher risk of diabetes progression (95% CI 1.35-2.11). Two-sample Mendelian randomization analysis showed per 1-unit genetically decreased rLTL was associated with a 1.38-fold higher risk of diabetes progression (95% CI 1.12-1.70). CONCLUSIONS Shorter rLTL was significantly associated with an increased risk of glycemic progression in individuals with type 2 diabetes, independent of established risk factors. Telomere length may be a useful biomarker for glycemic progression in people with type 2 diabetes.
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