Haugaard SB et al. – In these explorative analyses, the soluble urokinase plasminogen activator receptor associated independently with incident diabetes in non–smokers, supporting an immune origin of Type 2 diabetes. Competing disease risk may explain lack of association among smokers.Methods
- The Danish National Diabetes Register enabled more accurate identification of incident diabetes during a median follow-up of 13.8 years in the Danish MONICA 10 cohort (n = 2353 generally healthy individuals).
- The soluble urokinase plasminogen activator receptor was measured by the ELISA method.
- To fulfil model assumptions, outcome analyses were stratified by age, and further by smoking, owing to the interaction between the soluble urokinase plasminogen activator receptor and smoking on new-onset diabetes (P < 0.0001).
- New-onset diabetes (n = 182) was associated with increased soluble urokinase plasminogen activator receptor levels (P = 0.013).
- Among 699 middle-aged (41 and 51 years) and 564 older (61 and 71 years) non-smokers, participants in the upper soluble urokinase plasminogen activator receptor quartile had a sex- and age-adjusted relative risk of 6.01 (95% CI 2.17-16.6, P < 0.0006) and relative risk of 3.25 (95% CI 1.51-6.98, P = 0.0025), respectively, for new-onset diabetes compared with participants in the lowest quartile.
- This relationship remained significant after additional adjustments for C-reactive protein and leukocytes or fasting glucose and insulin or BMI (P < 0.05).
- The soluble urokinase plasminogen activator receptor was not related to incident diabetes among smokers (P ≥ 0.85).