Diabetes Metab J.  2020 Feb;44(1):134-142. 10.4093/dmj.2018.0273.

Plasma CD36 and Incident Diabetes: A Case-Cohort Study in Danish Men and Women

  • 1Health Services and Systems Research, Duke-NUS Medical School, Singapore.
  • 2Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. mkjensen@hsph.harvard.edu
  • 3Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
  • 4Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
  • 5Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • 6Danish Cancer Society Research Center, Copenhagen, Denmark.
  • 7Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
  • 8Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
  • 9Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.


Membrane CD36 is a fatty acid transporter implicated in the pathogenesis of metabolic disease. We aimed to evaluate the association between plasma CD36 levels and diabetes risk and to examine if the association was independent of adiposity among Danish population.
We conducted a case-cohort study nested within the Danish Diet, Cancer and Health study among participants free of cardiovascular disease, diabetes and cancer and with blood samples and anthropometric measurements (height, weight, waist circumference, and body fat percentage) at baseline (1993 to 1997). CD36 levels were measured in 647 incident diabetes cases that occurred before December 2011 and a total of 3,515 case-cohort participants (236 cases overlap).
Higher plasma CD36 levels were associated with higher diabetes risk after adjusting for age, sex and other lifestyle factors. The hazard ratio (HR) comparing high versus low tertile of plasma CD36 levels was 1.36 (95% confidence interval [CI], 1.00 to 1.86). However, the association lost its significance after further adjustment for different adiposity indices such as body mass index (HR, 1.23; 95% CI, 0.87 to 1.73), waist circumference (HR, 1.21; 95% CI, 0.88 to 1.68) or body fat percentage (HR, 1.20; 95% CI, 0.86 to 1.66). Moreover, raised plasma CD36 levels were moderately associated with diabetes risk among lean participants, but the association was not present among overweight/obese individuals.
Higher plasma CD36 levels were associated with higher diabetes risk, but the association was not independent of adiposity. In this Danish population, the association of CD36 with diabetes risk could be either mediated or confounded by adiposity.


Adiposity; Biomarkers; CD36 antigens; Diabetes mellitus, type 2; Epidemiology; Prospective studies

MeSH Terms

Adipose Tissue
Antigens, CD36
Body Mass Index
Cardiovascular Diseases
Diabetes Mellitus, Type 2
Life Style
Metabolic Diseases
Prospective Studies
Waist Circumference
Antigens, CD36


  • Fig. 1 Adjusted means of plasma CD36 according to adiposity measures: (A) high vs. low levels of body mass index (BMI); (B) high vs. low levels of waist circumference (WC); (C) high vs. low levels of body fat percentage. Means were adjusted for age and sex. Error bars indicate standard deviations. P heterogeneity values were tested between the different mean values of plasma CD36.

  • Fig. 2 Hazard ratios (HRs) for joint analyses between plasma CD36 levels and adiposity indices on incident diabetes: (A) CD36 levels and high vs. low levels of body mass index (BMI) on diabetes; (B) CD36 levels and high vs. low levels of waist circumference on diabetes; (C) CD36 levels and high vs. low levels of body fat percentage on diabetes. Hazard ratios are adjusted for age, sex, alcohol, smoking, physical activity, and education. Error bars indicate 95% confidence intervals. P trend values were calculated in sub-groups separately. SD, standard deviation.

Cited by  1 articles

The Role of CD36 in Type 2 Diabetes Mellitus: β-Cell Dysfunction and Beyond
Jun Sung Moon, Udayakumar Karunakaran, Elumalai Suma, Seung Min Chung, Kyu Chang Won
Diabetes Metab J. 2020;44(2):222-233.    doi: 10.4093/dmj.2020.0053.


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