Serum Immunoglobulin Concentrations and Risk of Type 2 Diabetes Mellitus in Adults: A Prospective Cohort Study

Abstract

Background: 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 T2DM. However, very few prospective studies are available on the link between immunoglobulins concentrations and risk of T2DM in adults. Hence, the aim of the present study was to investigate the associations between immunoglobulin levels and the risk of incident T2DM in a large cohort. Methods: The prospective study was performed among 6,245 adults in Tianjin, China. Participants without T2DM history were followed up for 1 to 8 years with a mean follow-up duration of 3*64 years. T2DM were diagnosed in accordance with the guidelines of the American Diabetes Association. Serum immunoglobulins levels were measured by the immunonephelometric assay. T2DM and immunoglobulins levels were assessed yearly during the follow-up. Multiple COX regression models were used to assess the association between serum immunoglobulin concentrations and the incidence of T2DM. Findings: The incidence of T2DM was 16*58 per 1,000 person-years. After multivariate adjustments, compared with the lowest quartiles, the hazard ratios (95% confidence intervals) of T2DM for the highest quartiles of IgG, IgE, IgM and IgA were 0*64(0*47-0*89), 1*01(0*75-1*35), 0*64(0*46-0*90) and 1*80(1*34-2*42) (P for trend were <0*01, 0*75, 0*01 and <0*0001), respectively. Interpretation: Our findings firstly suggest that IgG, IgM and IgA concentrations were independent predictors for developing T2DM. However, we found no association between IgE concentrations and the incidence of T2DM. Funding Statement: This study was supported by grants from the National Natural Science Foundation of China (No. 91746205, 81872611, and 81673166), China Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study protocol was approved by the Institutional Review Board of Tianjin Medical University. All participants had provided written informed consent prior to participation in the study.