Ethnic disparities in relationships of obesity indices with telomere length in Asians with type 2 diabetes

: 摘要: 背景 肥胖与端粒较短会增加糖尿病并发症与死亡的风险。然而，在不同的亚洲2型糖尿病人群中，肥胖与端粒长度之间的关系尚未明确。这项研究在多民族的亚洲2型糖尿病人群中调查基线时的肥胖指数与端粒长度的关系，并且观察这种关系随时间变化的情况。 方法 在SMART2D队列中，使用定量聚合酶链反应测定白细胞的端粒长度(leukocyte telomere length，LTL)(基线时n = 1431，经过中位数为3.2年的随访之后n = 1039)。通过线性回归来分析肥胖指数与LTL之间的关系。 结果 与中国人群相比，马来西亚人群的LTL较长(P < 0.0001)，而印度人群的LTL则相似。在中国人群中，从横断面来看，体重指数(BMI)-校正后的(残余)内脏脂肪面积(VFA；β = −0.004，P = 0.006)以及腰臀比(β = −1.95，P = 0.030)都与LTL显著相关，但是在马来西亚与印度人群中却无此相关性。只有在中国人群中，BMI(r=−0.080； P =0.053)以及VFA(r = −0.126；P = 0.002)的变化才与LTL的变化呈负相关。此外，在中国人群中BMI(β = −0.070；P = 0.040)以及VFA(β = −0.088，P = 0.028)每1-SD的增量变化都与更大的端粒消耗显著相关，而且这种相关性并不依赖于年龄、性别、糖尿病状况、基线LTL、肥胖以及炎症标志物。 结论 在中国2型糖尿病患者人群中，体重指数以及VFA的3年的变化与端粒的动态变化之间具有相关性，但是在马来西亚与印度人群中却无此相关性。在中国人群中，减少肥胖可能会降低与较短LTL相关的糖尿病并发症风险。. METHODS: Leukocyte telomere length (LTL) was measured by quantitative polymerase chain reaction in the SMART2D cohort (n = 1431 at baseline, n = 1039 after 3.2 years median follow-up). Associations between obesity indices and LTL were assessed by linear regression. RESULTS: Compared with Chinese, LTL was longer in Malays (P < 0.0001) and similar in Indians. Cross-sectionally, body mass index (BMI)-adjusted (residual) visceral fat area (VFA; β = -0.004, P = 0.006), and waist-to-hip ratio (β = -1.95, P = 0.030) were significantly associated with LTL in Chinese but not in Malays and Indians. Changes in BMI (r = -0.080; P = 0.053) and VFA (r = -0.126; P = 0.002) were inversely correlated with changes in LTL only in Chinese. Furthermore, in Chinese, 1-SD incremental changes in BMI (β = -0.070; P = 0.040) and VFA (β = -0.088, P = 0.028) were significantly associated with larger telomere attrition, independent of age, sex, diabetes condition, baseline LTL, obesity, and inflammation markers. CONCLUSIONS: Three-year changes in BMI and VFA were associated with telomere dynamics in Chinese but not in Malays and Indians with T2D. Reducing obesity may reduce the risk of diabetes complications associated with shorter LTL in the Chinese population.