期刊
DIABETOLOGIA
卷 60, 期 9, 页码 1712-1721出版社
SPRINGER
DOI: 10.1007/s00125-017-4329-9
关键词
Amino acid metabolism; Biomarkers; Clinical epidemiology; Type 2 diabetes
资金
- Norwegian Health Association
- Norwegian Extra Foundation for Health and Rehabilitation through EXTRA funds [2014/FOM5642]
- Norwegian Heart and Lung Patient Organisation
- Norwegian Ministry of Health and Care Services
- Western Norway Regional Health Authority
- Kristian Gerhard Jebsen Foundation
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
Aims/hypothesis The tryptophan metabolite kynurenine has potent immune modulatory and vasoactive properties. Experimental data implicate kynurenine in obesity-related morbidities. Epidemiological studies are, however, sparse. We evaluated associations of the plasma and urine kynurenine: tryptophan ratio (KTR) to incident type 2 diabetes. Methods We followed 2519 individuals with coronary artery disease (CAD; 73.1% men) without diabetes at baseline for a median of 7.6 years, during which 173 (6.9%) new incidences of type 2 diabetes were identified. Multivariate Cox regression analyses were applied to investigate the prospective relationships of plasma and urine KTR with new onset type 2 diabetes. Results At inclusion, mean (SD) age was 61.3 (10.4) years, BMI was 25.9 (3.71) kg/m(2) and median (interquartile range) HbA(1c) was 5.6% (5.0%-6.0%) (38 [31-42] mmol/mol). Plasma KTR was not significantly related to type 2 diabetes risk. By contrast, urine KTR showed a strong positive associ-ation. Comparing quartile 4 with quartile 1, the HRs (95% CIs) were 2.59 (1.56, 4.30) and 2.35 (1.39, 3.96) in the ageand sex-adjusted and multivariate models, respectively. Conclusions/interpretation Urine KTR is a strong predictor of incident type 2 diabetes in individuals with CAD. Potential clinical implications and possible pathogenic roles of renal kynurenine excretion in type 2 diabetes development should be further elucidated.
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