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Association of plasma β-amyloid 40 and 42 concentration with type 2 diabetes among Chinese adults



There is evidence for a bidirectional association between type 2 diabetes and Alzheimer’s disease. Plasma β-amyloid (Aβ) is a potential biomarker for Alzheimer’s disease. We aimed to investigate the association of plasma Aβ40 and Aβ42 with risk of type 2 diabetes.


We performed a case–control study and a nested case–control study within a prospective cohort study. In the case–control study, we included 1063 newly diagnosed individuals with type 2 diabetes and 1063 control participants matched by age (±3 years) and sex. In the nested case–control study, we included 121 individuals with incident type 2 diabetes and 242 matched control individuals. Plasma Aβ40 and Aβ42 concentrations were simultaneously measured with electrochemiluminescence immunoassay. Conditional logistic regression was used to evaluate the association of plasma Aβ40 and Aβ42 concentrations with the likelihood of type 2 diabetes.


In the case–control study, the multivariable-adjusted ORs for type 2 diabetes, comparing the highest with the lowest quartile of plasma Aβ concentrations, were 1.97 (95% CI 1.46, 2.66) for plasma Aβ40 and 2.01 (95% CI 1.50, 2.69) for plasma Aβ42. Each 30 ng/l increment of plasma Aβ40 was associated with 28% (95% CI 15%, 43%) higher odds of type 2 diabetes, and each 5 ng/l increment of plasma Aβ42 was associated with 37% (95% CI 21%, 55%) higher odds of type 2 diabetes. Individuals in the highest tertile for both plasma Aβ40 and Aβ42 concentrations had 2.96-fold greater odds of type 2 diabetes compared with those in the lowest tertile for both plasma Aβ40 and Aβ42 concentrations. In the nested case–control study, the multivariable-adjusted ORs for type 2 diabetes for the highest vs the lowest quartile were 3.79 (95% CI 1.81, 7.94) for plasma Aβ40 and 2.88 (95% CI 1.44, 5.75) for plasma Aβ42. The multivariable-adjusted ORs for type 2 diabetes associated with each 30 ng/l increment in plasma Aβ40 and each 5 ng/l increment in plasma Aβ42 were 1.44 (95% CI 1.18, 1.74) and 1.47 (95% CI 1.15, 1.88), respectively.


Our findings suggest positive associations of plasma Aβ40 and Aβ42 concentration with risk of type 2 diabetes. Further studies are warranted to elucidate the underlying mechanisms and explore the potential roles of plasma Aβ in linking type 2 diabetes and Alzheimer’s disease.

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Fig. 1

Data availability

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.





Amyloid precursor protein


Fasting plasma glucose


Fasting plasma insulin




Islet amyloid polypeptide




Meso Scale Discovery


Normal glucose tolerance


Tongji-Ezhou cohort


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We thank all participants in the two studies for their tireless dedication. We also thank X. Yu (Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China), and C. Xia and J. Zhang (Health Management Center, Ezhou Center for Disease Control and Prevention, Ezhou, China) for their assistance in data collection.

Authors’ relationships and activities

The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.


This work was funded by the National Key Research and Development Program of China (2017YFC1600500), the Major International (Regional) Joint Research Project (NSFC 81820108027) and the National Natural Science Foundation of China (81773423 and 21537001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

XBP, ZX and LL designed the study. XBP, ZX, XM, QG, JY, MX, ZP, TS, LZ, XLP, SX, WY, WB, ZS and XL contributed to the acquisition, analysis or interpretation of data collection. XBP wrote the manuscript. ZX, XM, QG, JY, MX, ZP, TS, LZ, XLP, SX, WY, WB, ZS, XL and LL contributed to reviewing and revising the paper. All authors read and approved the final manuscript. LL is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Correspondence to Xiaoqin Li or Liegang Liu.

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Peng, X., Xu, Z., Mo, X. et al. Association of plasma β-amyloid 40 and 42 concentration with type 2 diabetes among Chinese adults. Diabetologia (2020).

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  • Alzheimer’s disease
  • β-amyloid 40
  • β-amyloid 42
  • Case–control
  • Nested case–control
  • Type 2 diabetes