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. 2024 May 23;8(7):bvae097.
doi: 10.1210/jendso/bvae097.

Soluble CD14 and Incident Diabetes Risk: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Kaileen Cruden  1 , Katherine Wilkinson  2 , Debora Kamin Mukaz  3 , Timothy B Plante  3 , Neil A Zakai  2   3 , D Leann Long  4 , Mary Cushman  2   3 , Nels C Olson  2
Affiliations

Soluble CD14 and Incident Diabetes Risk: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Kaileen Cruden et al. J Endocr Soc. .

Abstract

Context: Soluble CD14 (sCD14) is an inflammation biomarker with higher concentrations in White than Black adults. Higher sCD14 is seen in insulin resistance and diabetes. There are limited data on the relationship between sCD14 and incident diabetes.

Objective: To determine the association of sCD14 with incident diabetes risk in a large biracial US cohort and evaluate whether relationships differ by race.

Design: This study included 3401 Black and White participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study without baseline diabetes who completed baseline and follow-up in-home visits. Modified Poisson regression models estimated risk ratios (RR) of incident diabetes per 1-SD increment sCD14, with adjustment for risk factors. A sCD14-by-race interaction evaluated whether associations differed by race.

Results: There were 460 cases of incident diabetes over a mean 9.5 years of follow-up. The association of sCD14 with diabetes differed by race (P for interaction < .09). Stratifying by race, adjusting for age, sex, and region, higher sCD14 was associated with incident diabetes in White (RR: 1.15; 95% CI: 1.01, 1.33) but not Black participants (RR: 0.96; 95% CI: 0.86, 1.08). In models adjusted for clinical and sociodemographic diabetes risk factors, the association was attenuated among White participants (RR: 1.10; 95% CI: 0.95, 1.28) and remained null among Black participants (RR: 0.90; 95% CI: 0.80, 1.01).

Conclusion: sCD14 was associated with incident diabetes risk in White but not Black adults, but this association was explained by diabetes risk factors.

Keywords: biomarkers; diabetes; inflammation; racial groups.

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Figures

Figure 1.
Figure 1.
Restricted cubic spline modeling of sCD14 with incident diabetes risk stratified by race. Solid lines represent risk ratios; shaded areas represent 95% confidence intervals. Knots were race-specific, located at 944, 1281, and 1726 pg/mL with the reference category set at 1292 pg/mL among Black participants. Among White participants knots were located at 1068, 1395, and 1829 pg/mL with the reference set at 1395 pg/mL. Analyses adjusted for age, sex, and region.
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