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Comparing the inflammatory profiles for incidence of diabetes mellitus and cardiovascular diseases : A prospective study exploring the 'common soil' hypothesis

Bao, Xue LU ; Borné, Yan LU ; Johnson, Linda LU ; Muhammad, Iram Faqir LU ; Persson, Margaretha LU ; Niu, Kaijun and Engström, Gunnar LU (2018) In Cardiovascular Diabetology 17(1).
Abstract

Background: Chronic low-grade inflammation and associated insulin resistance and metabolic abnormalities have been proposed as 'common soil' for diabetes mellitus (DM) and cardiovascular disease (CVD). This paper aimed to investigate the inflammatory profiles of DM and CVD and to distinguish their shared and specific markers. Methods: Based on the Malmö Diet and Cancer cohort, total and differential leukocyte counts were measured in 25,969 participants without previous DM or CVD and were studied in relation to incident DM (mean follow-up 17.4±5.58years) and incident CVD (i.e., coronary events, including fatal and nonfatal myocardial infarction, or stroke); mean follow-up 17.7±5.46years, using multivariable Cox regression models.... (More)

Background: Chronic low-grade inflammation and associated insulin resistance and metabolic abnormalities have been proposed as 'common soil' for diabetes mellitus (DM) and cardiovascular disease (CVD). This paper aimed to investigate the inflammatory profiles of DM and CVD and to distinguish their shared and specific markers. Methods: Based on the Malmö Diet and Cancer cohort, total and differential leukocyte counts were measured in 25,969 participants without previous DM or CVD and were studied in relation to incident DM (mean follow-up 17.4±5.58years) and incident CVD (i.e., coronary events, including fatal and nonfatal myocardial infarction, or stroke); mean follow-up 17.7±5.46years, using multivariable Cox regression models. Furthermore, plasma concentrations of another seven inflammatory markers were examined in relation to incident DM and incident CVD in a sub-cohort of 4658 participants. The associations of each inflammatory marker with incident DM versus incident CVD were compared using the Lunn-McNeil competing risks approach. In sensitivity analyses, those who developed both DM and CVD during follow-up were excluded. Results: After adjustment for conventional risk factors, total and differential leukocyte counts, orosomucoid, and C-reactive protein were associated with an increased risk of both DM and CVD. Neutrophil to lymphocyte ratio, ceruloplasmin, alpha1-antitrypsin and soluble urokinase plasminogen activator receptor predicted increased risk of CVD but not DM, while haptoglobin and complement C3 showed the opposite pattern. In competing risks analyses, lymphocyte count and complement C3 had stronger associations with risk of DM than with risk of CVD (p for equal associations=0.020 and 0.006). The reverse was true for neutrophil to lymphocyte ratio (p for equal associations=0.025). Results were consistent in sensitivity analyses. Conclusions: The results indicated substantial similarities in the inflammatory profiles associated with DM and CVD. However, there are also significant differences. These findings may help discriminate between individuals at elevated risk of DM and those at elevated risk of CVD, which is a prerequisite for targeted therapies.

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type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular diseases, Cohort study, Competing risks analysis, Diabetes mellitus, Inflammatory markers, Proportional hazards models, Survival analysis
in
Cardiovascular Diabetology
volume
17
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85048474301
ISSN
1475-2840
DOI
10.1186/s12933-018-0733-9
language
English
LU publication?
yes
id
ef8be549-e342-432d-a4de-68a80ab3f13b
date added to LUP
2018-06-28 15:35:21
date last changed
2019-08-14 04:19:11
@article{ef8be549-e342-432d-a4de-68a80ab3f13b,
  abstract     = {<p>Background: Chronic low-grade inflammation and associated insulin resistance and metabolic abnormalities have been proposed as 'common soil' for diabetes mellitus (DM) and cardiovascular disease (CVD). This paper aimed to investigate the inflammatory profiles of DM and CVD and to distinguish their shared and specific markers. Methods: Based on the Malmö Diet and Cancer cohort, total and differential leukocyte counts were measured in 25,969 participants without previous DM or CVD and were studied in relation to incident DM (mean follow-up 17.4±5.58years) and incident CVD (i.e., coronary events, including fatal and nonfatal myocardial infarction, or stroke); mean follow-up 17.7±5.46years, using multivariable Cox regression models. Furthermore, plasma concentrations of another seven inflammatory markers were examined in relation to incident DM and incident CVD in a sub-cohort of 4658 participants. The associations of each inflammatory marker with incident DM versus incident CVD were compared using the Lunn-McNeil competing risks approach. In sensitivity analyses, those who developed both DM and CVD during follow-up were excluded. Results: After adjustment for conventional risk factors, total and differential leukocyte counts, orosomucoid, and C-reactive protein were associated with an increased risk of both DM and CVD. Neutrophil to lymphocyte ratio, ceruloplasmin, alpha1-antitrypsin and soluble urokinase plasminogen activator receptor predicted increased risk of CVD but not DM, while haptoglobin and complement C3 showed the opposite pattern. In competing risks analyses, lymphocyte count and complement C3 had stronger associations with risk of DM than with risk of CVD (p for equal associations=0.020 and 0.006). The reverse was true for neutrophil to lymphocyte ratio (p for equal associations=0.025). Results were consistent in sensitivity analyses. Conclusions: The results indicated substantial similarities in the inflammatory profiles associated with DM and CVD. However, there are also significant differences. These findings may help discriminate between individuals at elevated risk of DM and those at elevated risk of CVD, which is a prerequisite for targeted therapies.</p>},
  articleno    = {87},
  author       = {Bao, Xue and Borné, Yan and Johnson, Linda and Muhammad, Iram Faqir and Persson, Margaretha and Niu, Kaijun and Engström, Gunnar},
  issn         = {1475-2840},
  keyword      = {Cardiovascular diseases,Cohort study,Competing risks analysis,Diabetes mellitus,Inflammatory markers,Proportional hazards models,Survival analysis},
  language     = {eng},
  month        = {06},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Cardiovascular Diabetology},
  title        = {Comparing the inflammatory profiles for incidence of diabetes mellitus and cardiovascular diseases : A prospective study exploring the 'common soil' hypothesis},
  url          = {http://dx.doi.org/10.1186/s12933-018-0733-9},
  volume       = {17},
  year         = {2018},
}