河南农村人群C反应蛋白在血清黄体酮与2型糖尿病关联中的中介效应

Mediation effects of C-reactive protein on association of serum progesterone with type 2 diabetes mellitus in Henan rural population

目的:探讨河南农村人群中血清黄体酮与2型糖尿病(T2DM)的关联,并进一步确定C反应蛋白(CRP)在这种关联的中介作用。方法:研究对象来自河南农村队列研究中的4665名参与者,采用Logistic回归分析和线性回归分析评估黄体酮、CRP与T2DM、糖代谢指标[空腹血糖(FPG)和胰岛素(INS)]之间的关系,并以CRP为中介变量评估其在黄体酮与T2DM、FPG和INS关联的中介效应。结果:在调整了所有混杂因素之后,血清黄体酮与T2DM的患病风险增加有关联[OR(95%CI)=1.56(1.31~1.86)],与血清CRP、FPG和INS的浓度升高有关联[β(95%CI)=0.08(0.03~0.13)、0.13(0.09~0.17)、0.31(0.13~0.48)]。此外,血清CRP与T2DM的患病风险增加有关联[OR(95%CI)=1.64(1.39~1.93)],与FPG的浓度升高有关联[β(95%CI)=0.14(0.09~0.19)]。中介分析显示CRP在血清黄体酮水平与T2DM、FPG和INS之间存在部分中介效应[OR/β(95%CI)=1.01(1.01~1.03)、0.01(0.00~0.01)、0.01(0.00~0.02)]。结论:在中国农村人群中,血清黄体酮和CRP浓度升高都可能会增加患T2DM的风险,并且CRP在血清黄体酮与T2DM、FPG和INS之间存在部分中介效应。

Aim:To explore the association of serum progesterone with type 2 diabetes mellitus(T2DM)in Henan rural cohort and then further determine the potential role of C-reactive protein(CRP)in this association.Methods:A total of 4665 participants from Henan rural cohort study were included.Logistic regression analysis and linear regression analysis were performed to estimate the relationships of progesterone and CRP with T2DM,and glucose metabolism indexes(FPG and INS).Mediation analysis was carried out to assess the intermediary role of CRP played in the associations.Results:After controlling for confounders,progesterone was associated with T2DM[OR(95%CI)=1.56(1.31-1.86)]and with elevated concentrations of serum CRP,FPG and INS[β(95%CI)=0.08(0.03-0.13),0.13(0.09-0.17)and 0.31(0.13-0.48)].Also,CRP was associated with T2DM[OR(95%CI)=1.64(1.39-1.93)]and with elevated concentration of FPG[β(95%CI)=0.14(0.09-0.19)].Mediation analysis revealed a partial mediating effect of CRP between progesterone and T2DM,FPG and INS[OR/β(95%CI)=1.01(1.01-1.03),0.01(0.00-0.01),0.01(0.00-0.02)].Conclusion:In the Chinese rural population,serum progesterone and elevated concentration of CRP are related to T2DM,and CRP partly mediates the effects of progesterone on T2DM,FPG,and INS.