| Aims: Type 2 diabetes mellitus(T2DM)has emerged as a global epidemic due to lifestyle changes and urbanization.Numerous experimental studies have demonstrated that inflammation plays an important role in the etiology of T2 DM.However,very few prospective studies are available on the link between immunoglobulins and risk of T2 DM in adults.Hence,the aim of the present study was to explore the associations between immunoglobulins levels and risk of incident T2 DM in adults based on a cohort study.Methods: This cohort study was based on the “Tianjin Chronic Low-grade Systemic Inflammation and Health(TCLSIHealth)” cohort.Participants were recruited from “TCLSIHealth” cohort who measured the levels of immunoglobulin and glucose since 2010.The total number of participants eligible for the study was 4,263.Data of baseline and follow-up were collected from self-administered questionnaires,physical examination and laboratory tests.The questionnaire included the information on demographic characteristics such as gender,age,marital status,occupation and educational background;lifestyles such as smoking,drinking,physical activity and sleep;disease history;medication history and family history of diseases.Physical examination included height,weight,blood pressure and waist circumference.Laboratory tests included serum immunoglobulin,blood glucose and lipid level and white blood cell count.New cases of T2 DM were diagnosed in accordance with the guidelines of the American Diabetes Association.Serum immunoglobulins levels were measured by the immunonephelometric assay.Statistical analyses were conducted using software SAS 9.3 version.Analysis of covariance for continuous variables and logistic regression analysis for proportional variables were used to compared differences in baseline characteristics analysis after adjustment for age.Multiple COX regression models were used to assess the association between serum immunoglobulin concentrations and T2 DM.The hazard ratios(HRs)and corresponding 95% confidence intervals(CIs)were calculated.Results: During the follow-up,the incidence rate of T2 DM was 10.89 per 1,000 person-years in study population.The incidence rate of T2 DM was 14.55 per 1,000 person-years in males and 5.45 per 1,000 person-years in females.After multivariate adjustments(age,sex,body mass index,waist circumference,white blood cell counts,smoking habits,drinking status,metabolic syndrome,hypertension,hyperlipidemia,family history of diseases,eosinophil proportion counts and mutual other types of immunoglobulins),compared with the lowest quintile,the HRs(95% CIs)of T2 DM for the highest quintile of immunoglobulins(immunoglobulin G,IgG;immunoglobulin E,IgE;immunoglobulin M,IgM,and immunoglobulin A,IgA)were 0.71(0.46,1.11),0.91(0.60,1.38),0.58(0.37,0.92)and 1.49(1.01,2.22),(P for trend were 0.13,0.60,0.02 and 0.03),respectively.In males,compared with the lowest quintile,the adjustedHRs(95% CIs)of T2 DM for the highest quintile of immunoglobulins(IgG,IgE,IgM,IgA)were 0.73(0.45,1.18),0.82(0.52,1.30),0.68(0.42,1.08)and 1.79(1.15,2.81)(P for trend were 0.26,0.41,0.11 and <0.01),respectively.In females,compared with the lowest quintile,the adjusted-HRs(95% CIs)of T2 DM for the highest quintile of immunoglobulins(IgG,IgE,IgM,IgA)were 0.68(0.27,1.72),1.04(0.42,2.56),0.54(0.19,1.53)and 0.59(0.21,1.65)(P for trend were 0.36,0.85,0.18 and 0.35),respectively.Conclusions: In the study population,serum IgM concentrations were invesely associated with the incidence of T2 DM,and IgA levels were positively associated with risk of T2 DM.In males,elevated IgA concentrations were positively associated with the incidence of T2 DM.However,no significant association between immunoglobulin concenrations and T2 DM was observed in females.These results suggested that elevated IgA concentration may be a predictor of T2 DM in males.Further studies are necessary to confirm these findings. |
PDF Full Text Request