CAJ | 학술논문

目的观察血清补体3（C3）水平升高是否增加2型糖尿病（T2DM）的发生风险。方法本研究为巢式病例对照研究，以重庆某社区非糖尿病人群为研究对象，收集临床资料并追踪随访5年，分别在基线和随访期间行口服75 g葡萄糖耐量试验（OGTT）。按1∶1选取与新诊断T2DM性别、年龄、体质指数（BMI）匹配的糖耐量正常者作为对照组。采用条件Logistic回归分析C3对T2DM发病的影响。结果在5年随访期间，3510名受试者中新诊断T2DM患者255例，男/女例数为141/114，年龄为（61±10）岁，对照组例数、年龄与糖尿病组相同。T2DM组基线血清C3水平较对照组明显升高[（1.29±0.23）比（1.25±0.21）g/L，t=-2.017，P<0.05]。在校正吸烟、糖尿病家族史、体育锻炼、低密度脂蛋白胆固醇及收缩压等多个因素后，条件Logistic回归分析显示C3水平升高增加T2DM发生风险（OR=1.652，95%CI：1.004~2.717，P<0.05），且血清C3水平与T2DM发生风险的关系主要存在于年龄≥55岁、BMI≥24 kg/m2、总胆固醇≥5.2 mmol/L或甘油三酯<1.70 mmol/L的人群中（OR=1.138~2.156，均P<0.05）。结论血清C3或能预测T2DM的发生。
목적관찰혈청보체3（C3）수평승고시부증가2형당뇨병（T2DM）적발생풍험。방법본연구위소식병례대조연구，이중경모사구비당뇨병인군위연구대상，수집림상자료병추종수방5년，분별재기선화수방기간행구복75 g포도당내량시험（OGTT）。안1∶1선취여신진단T2DM성별、년령、체질지수（BMI）필배적당내량정상자작위대조조。채용조건Logistic회귀분석C3대T2DM발병적영향。결과재5년수방기간，3510명수시자중신진단T2DM환자255례，남/녀례수위141/114，년령위（61±10）세，대조조례수、년령여당뇨병조상동。T2DM조기선혈청C3수평교대조조명현승고[（1.29±0.23）비（1.25±0.21）g/L，t=-2.017，P<0.05]。재교정흡연、당뇨병가족사、체육단련、저밀도지단백담고순급수축압등다개인소후，조건Logistic회귀분석현시C3수평승고증가T2DM발생풍험（OR=1.652，95%CI：1.004~2.717，P<0.05），차혈청C3수평여T2DM발생풍험적관계주요존재우년령≥55세、BMI≥24 kg/m2、총담고순≥5.2 mmol/L혹감유삼지<1.70 mmol/L적인군중（OR=1.138~2.156，균P<0.05）。결론혈청C3혹능예측T2DM적발생。
Objective To investigate whether elevated levels of serum complement factor 3 (C3) increase the risk of developing type 2 diabetes mellitus (T2DM). Methods This was a nested case-control study. Non-diabetic inhabitants from a community in Chongqing were enrolled and followed up for 5 years. Clinical data were collected. Oral glucose tolerance test (OGTT) was performed at baseline and every 1-2 years. Controls were randomly selected in a 1∶1 ratio to match new T2DM cases according to age, gender, and body mass index(BMI). Odds ratios (OR) for T2DM were calculated by conditional Logistic regression analysis. Results A total of 255 subjects out of the 3 510 subjects developed T2DM during the 5-year follow-up. There were 141 males and 114 females in the T2DM group, aged (61±10) yrs vs (61±10) yrs in control group. The levels of serum C3 was higher in T2DM group than in control group at baseline ((1.29±0.23) vs (1.25 ± 0.21) g/L, t=-2.017, P<0.05). After adjusting for age, gender, BMI, smoking history, family history of diabetes, physical activity, low density lipoprotein cholesterol levels and systolic blood pressure, the risk of developing T2DM was still closely associated with elevated serum C3 levels(OR=1.652, 95%CI:1.004-2.717, P<0.05). This correlation occurred mainly in the subjects with age>55 yrs old, BMI≥24 kg/m2, total cholesterol≥5.2 mmol/L or triglyceride<1.70 mmol/L(OR= 1.138-2.156, all P<0.05). Conclusion Serum C3 levels may predict the development of T2DM.