The following is a summary of “Soluble CD14 and Incident Diabetes Risk: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study,” published in the July 2024 issue of Endocrinology by Cruden, et al.
Soluble CD14 (sCD14) serves as an inflammation biomarker, demonstrating higher concentrations in White adults than Black adults. Elevated sCD14 levels are associated with insulin resistance and diabetes, yet data on its relationship with incident diabetes remain limited. For a study, researchers sought to investigate the association between sCD14 levels and incident diabetes risk in a large biracial cohort from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study and to assess whether this association varies by race.
The study included 3,401 Black and White participants from REGARDS without diabetes at baseline, who completed initial and follow-up in-home visits. Modified Poisson regression models were used to estimate risk ratios (RR) for incident diabetes per 1-standard deviation increment in sCD14, adjusting for relevant risk factors. Interaction terms assessed whether race modified these associations.
Over a mean follow-up of 9.5 years, 460 incident diabetes cases were identified. The association between sCD14 and diabetes risk differed by race (P for interaction < 0.09). Stratifying by race and adjusting for age, sex, and region, higher sCD14 levels were associated with increased diabetes risk among White participants (RR: 1.15; 95% CI: 1.01, 1.33) but not among Black participants (RR: 0.96; 95% CI: 0.86, 1.08). After further adjustment for clinical and sociodemographic diabetes risk factors, the association among White participants attenuated (RR: 1.10; 95% CI: 0.95, 1.28) while remaining null among Black participants (RR: 0.90; 95% CI: 0.80, 1.01).
Elevated sCD14 levels were associated with increased incident diabetes risk in White adults, but traditional diabetes risk factors mediated this association. No significant association was observed in Black adults, highlighting potential racial differences in the pathophysiology of diabetes development related to sCD14 levels.