Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes

Background: Evidence from animal models and observational epidemiology points to a role for chronic inflammation, in which interleukin 6 (IL-6) is a key player, in the pathophysiology of type 2 diabetes (T2D). However, it is unknown whether IL-6 mediated inflammation is implicated in the pathophysio...

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Main Authors: Nicholas Bowker, Rupal L. Shah, Stephen J. Sharp, Jian'an Luan, Isobel D. Stewart, Eleanor Wheeler, Manuel A.R. Ferreira, Aris Baras, Nicholas J. Wareham, Claudia Langenberg, Luca A. Lotta
Format: Article
Language:English
Published: Elsevier 2020-11-01
Series:EBioMedicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352396420304382
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author Nicholas Bowker
Rupal L. Shah
Stephen J. Sharp
Jian'an Luan
Isobel D. Stewart
Eleanor Wheeler
Manuel A.R. Ferreira
Aris Baras
Nicholas J. Wareham
Claudia Langenberg
Luca A. Lotta
author_facet Nicholas Bowker
Rupal L. Shah
Stephen J. Sharp
Jian'an Luan
Isobel D. Stewart
Eleanor Wheeler
Manuel A.R. Ferreira
Aris Baras
Nicholas J. Wareham
Claudia Langenberg
Luca A. Lotta
author_sort Nicholas Bowker
collection DOAJ
description Background: Evidence from animal models and observational epidemiology points to a role for chronic inflammation, in which interleukin 6 (IL-6) is a key player, in the pathophysiology of type 2 diabetes (T2D). However, it is unknown whether IL-6 mediated inflammation is implicated in the pathophysiology of T2D. Methods: We performed a meta-analysis of 15 prospective studies to investigate associations between IL-6 levels and incident T2D including 5,421 cases and 31,562 non-cases. We also estimated the association of a loss-of-function missense variant (Asp358Ala) in the IL-6 receptor gene (IL6R), previously shown to mimic the effects of IL-6R inhibition, in a large trans-ethnic meta-analysis of six T2D case-control studies including 260,614 cases and 1,350,640 controls. Findings: In a meta-analysis of 15 prospective studies, higher levels of IL-6 (per log pg/mL) were significantly associated with a higher risk of incident T2D (1·24 95% CI, 1·17, 1·32; P = 1 × 10−12). In a trans-ethnic meta-analysis of 260,614 cases and 1,350,640 controls, the IL6R Asp358Ala missense variant was associated with lower odds of T2D (OR, 0·98; 95% CI, 0·97, 0·99; P = 2 × 10−7). This association was not due to diagnostic misclassification and was consistent across ethnic groups. IL-6 levels mediated up to 5% of the association between higher body mass index and T2D. Interpretation: Large-scale human prospective and genetic data provide evidence that IL-6 mediated inflammation is implicated in the etiology of T2D but suggest that the impact of this pathway on disease risk in the general population is likely to be small. Funding: The EPICNorfolk study has received funding from the Medical Research Council (MRC) (MR/N003284/1, MC-UU_12015/1 and MC_PC_13048) and Cancer Research UK (C864/A14136). The Fenland Study is funded by the MRC (MC_UU_12015/1 and MC_PC_13046).
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spelling doaj.art-03fdad420e2e4ab992a54d99154a0ddf2022-12-22T00:08:58ZengElsevierEBioMedicine2352-39642020-11-0161103062Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetesNicholas Bowker0Rupal L. Shah1Stephen J. Sharp2Jian'an Luan3Isobel D. Stewart4Eleanor Wheeler5Manuel A.R. Ferreira6Aris Baras7Nicholas J. Wareham8Claudia Langenberg9Luca A. Lotta10MRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomRegeneron Genetics Center, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, United StatesRegeneron Genetics Center, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, United StatesMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United KingdomMRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom; Corresponding author.MRC Epidemiology Unit, University of Cambridge, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom; Regeneron Genetics Center, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, United StatesBackground: Evidence from animal models and observational epidemiology points to a role for chronic inflammation, in which interleukin 6 (IL-6) is a key player, in the pathophysiology of type 2 diabetes (T2D). However, it is unknown whether IL-6 mediated inflammation is implicated in the pathophysiology of T2D. Methods: We performed a meta-analysis of 15 prospective studies to investigate associations between IL-6 levels and incident T2D including 5,421 cases and 31,562 non-cases. We also estimated the association of a loss-of-function missense variant (Asp358Ala) in the IL-6 receptor gene (IL6R), previously shown to mimic the effects of IL-6R inhibition, in a large trans-ethnic meta-analysis of six T2D case-control studies including 260,614 cases and 1,350,640 controls. Findings: In a meta-analysis of 15 prospective studies, higher levels of IL-6 (per log pg/mL) were significantly associated with a higher risk of incident T2D (1·24 95% CI, 1·17, 1·32; P = 1 × 10−12). In a trans-ethnic meta-analysis of 260,614 cases and 1,350,640 controls, the IL6R Asp358Ala missense variant was associated with lower odds of T2D (OR, 0·98; 95% CI, 0·97, 0·99; P = 2 × 10−7). This association was not due to diagnostic misclassification and was consistent across ethnic groups. IL-6 levels mediated up to 5% of the association between higher body mass index and T2D. Interpretation: Large-scale human prospective and genetic data provide evidence that IL-6 mediated inflammation is implicated in the etiology of T2D but suggest that the impact of this pathway on disease risk in the general population is likely to be small. Funding: The EPICNorfolk study has received funding from the Medical Research Council (MRC) (MR/N003284/1, MC-UU_12015/1 and MC_PC_13048) and Cancer Research UK (C864/A14136). The Fenland Study is funded by the MRC (MC_UU_12015/1 and MC_PC_13046).http://www.sciencedirect.com/science/article/pii/S2352396420304382Interleukin-6Type 2 diabetesGeneticTrans-ethnic
spellingShingle Nicholas Bowker
Rupal L. Shah
Stephen J. Sharp
Jian'an Luan
Isobel D. Stewart
Eleanor Wheeler
Manuel A.R. Ferreira
Aris Baras
Nicholas J. Wareham
Claudia Langenberg
Luca A. Lotta
Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes
EBioMedicine
Interleukin-6
Type 2 diabetes
Genetic
Trans-ethnic
title Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes
title_full Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes
title_fullStr Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes
title_full_unstemmed Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes
title_short Meta-analysis investigating the role of interleukin-6 mediated inflammation in type 2 diabetes
title_sort meta analysis investigating the role of interleukin 6 mediated inflammation in type 2 diabetes
topic Interleukin-6
Type 2 diabetes
Genetic
Trans-ethnic
url http://www.sciencedirect.com/science/article/pii/S2352396420304382
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