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Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults
BACKGROUND: The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. METHODS: A total 14,393 hyp...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585682/ https://www.ncbi.nlm.nih.gov/pubmed/33099298 http://dx.doi.org/10.1186/s12933-020-01161-x |
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author | Zhang, Yuanyuan Zhou, Chun Li, Jianping Zhang, Yan Xie, Di Liang, Min Wang, Binyan Song, Yun Wang, Xiaobin Huo, Yong Hou, Fan Fan Xu, Xiping Qin, Xianhui |
author_facet | Zhang, Yuanyuan Zhou, Chun Li, Jianping Zhang, Yan Xie, Di Liang, Min Wang, Binyan Song, Yun Wang, Xiaobin Huo, Yong Hou, Fan Fan Xu, Xiping Qin, Xianhui |
author_sort | Zhang, Yuanyuan |
collection | PubMed |
description | BACKGROUND: The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. METHODS: A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG < 6.1 mmol/L at baseline and ≥ 6.1 but < 7.0 mmol/L at the exit visit. RESULTS: Over a median of 4.5 years follow-up, 1549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95% CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95% CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) < 10 μmol/L (adjusted OR, 1.24; 95% CI: 1.10, 1.40 vs. ≥ 10 μmol/L: adjusted OR, 1.03; 95% CI: 0.96, 1.10; P-interaction = 0.007) or FG ≥ 5.9 mmol/L (adjusted OR, 1.16; 95% CI: 1.07, 1.27 vs. < 5.9 mmol/L: adjusted OR, 1.00; 95% CI: 0.93, 1.08; P-interaction = 0.009) CONCLUSIONS: In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels. Clinical Trial Registration-URL Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008. |
format | Online Article Text |
id | pubmed-7585682 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-75856822020-10-26 Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults Zhang, Yuanyuan Zhou, Chun Li, Jianping Zhang, Yan Xie, Di Liang, Min Wang, Binyan Song, Yun Wang, Xiaobin Huo, Yong Hou, Fan Fan Xu, Xiping Qin, Xianhui Cardiovasc Diabetol Original Investigation BACKGROUND: The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. METHODS: A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG < 6.1 mmol/L at baseline and ≥ 6.1 but < 7.0 mmol/L at the exit visit. RESULTS: Over a median of 4.5 years follow-up, 1549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95% CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95% CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) < 10 μmol/L (adjusted OR, 1.24; 95% CI: 1.10, 1.40 vs. ≥ 10 μmol/L: adjusted OR, 1.03; 95% CI: 0.96, 1.10; P-interaction = 0.007) or FG ≥ 5.9 mmol/L (adjusted OR, 1.16; 95% CI: 1.07, 1.27 vs. < 5.9 mmol/L: adjusted OR, 1.00; 95% CI: 0.93, 1.08; P-interaction = 0.009) CONCLUSIONS: In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels. Clinical Trial Registration-URL Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008. BioMed Central 2020-10-24 /pmc/articles/PMC7585682/ /pubmed/33099298 http://dx.doi.org/10.1186/s12933-020-01161-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Investigation Zhang, Yuanyuan Zhou, Chun Li, Jianping Zhang, Yan Xie, Di Liang, Min Wang, Binyan Song, Yun Wang, Xiaobin Huo, Yong Hou, Fan Fan Xu, Xiping Qin, Xianhui Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
title | Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
title_full | Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
title_fullStr | Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
title_full_unstemmed | Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
title_short | Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
title_sort | serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585682/ https://www.ncbi.nlm.nih.gov/pubmed/33099298 http://dx.doi.org/10.1186/s12933-020-01161-x |
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