All-Cause Mortality Differentials by Diabetes Status and Serum Neurofilament Light-Chain Levels in US General Adults
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM(2024)
摘要
Context Neurofilament light chains (sNFLs) increase in patients with diabetes (DM) and are associated with death.Objective This work aimed to examine whether sNFL mediates associations of DM with all-cause mortality and the extent of interaction or joint relations of sNFL and DM with mortality.Methods This population-based cohort study was conducted using the 2013 to 2014 cycle of the National Health and Nutrition Examination Survey. A total of 2071 adults aged 20 to 75 years with sNFL measurements were included. sNFL was lg-transformed (LgNfl). Participants were included whose LgNfl was higher than 1.48 pg/mL or who were diagnosed with DM. All-cause mortality was the primary outcome obtained through linkage to registries.Results During a median follow-up of 6.1years, 85 participants died. Incidence rates (per 1000 person-years [95% CI]) of all-cause mortality were 27.78 (19.98 similar to 35.58) in adults with LgNfl greater than 1.48 pg/mL and DM, 9.01 (1.99 similar to 16.03) in adults with LgNfl greater than 1.48 pg/mL but no DM, 3.07 (1.01 similar to 5.13) in adults with DM and LgNfl less than or equal to 1.48 pg/mL, and 2.21 (1.15 similar to 3.27) in adults without DM and LgNfl less than or equal to 1.48 pg/mL. Significant interaction but not mediation was observed between LgNfl and DM. Compared with adults without DM and LgNfl less than or equal to 1.48 pg/mL, those with DM and LgNfl greater than 1.48 pg/mL had higher risks of all-cause mortality (hazard ratio; 95% CI, 7.06; 3.52 similar to 14.16).Conclusion In general US adults with DM, elevated sNFLs were associated with higher all-cause mortality specifically, supporting an important role of sNFLs in predicting health outcome in individuals with DM.
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关键词
serum neurofilament light chain,diabetes,all-cause mortality,neurologic disorders
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