Longitudinal effects of Johnson & Johnson COVID-19 vaccination on metabolic biomarkers in type 2 diabetes mellitus in Ethiopia

doi:10.4239/wjd.v16.i6.105447

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Prospective Study

World J Diabetes. Jun 15, 2025; 16(6): 105447
Published online Jun 15, 2025. doi: 10.4239/wjd.v16.i6.105447

Table 1 Baseline characteristics of study participants in relation to vaccination status, n (%)

Variables	Categories	COVID-19 vaccination status		P value¹	Total
Variables	Categories	Vaccinated, n = 57 (25.5)	Unvaccinated, n = 167 (74.5)	P value¹	Total
Age	≤ 40 years	23 (28.4)	58 (71.6)	0.446	81 (36.2)
Age	> 40 years	34 (23.8)	109 (76.2)	0.446	143 (63.8)
Sex	Female	29 (25.2)	86 (74.8)	0.936	115 (51.3)
Sex	Male	28 (25.7)	81 (74.3)	0.936	109 (48.7)
Alcohol	Yes	15 (32.6)	31 (67.4)	0.211	46 (20.5)
Alcohol	No	42 (23.6)	136 (76.4)	0.211	178 (79.5)
Chat	Yes	8 (33.3)	16 (66.7)	0.348	24 (10.7)
Chat	No	49 (24.5)	151 (75.5)	0.348	200 (89.3)
Smoking	Yes	3 (50.0)	3 (50.0)	0.174	6 (2.7)
Smoking	No	54 (24.8)	164 (75.2)	0.174	218 (97.3)
Medications	Insulin	13 (23.2)	43 (76.8)	0.399	56 (25.0)
	Metformin	24 (22.9)	81 (77.1)		105 (46.9)
	Both	20 (31.8)	43 (68.3)		63 (28.1)

¹Fisher’s exact-test.

COVID-19: Coronavirus disease 2019.

Table 2 Longitudinal changes in lipid and eicosanoid biomarkers in the vaccinated and unvaccinated groups

Outcomes	Baseline		3 months		6 months		9 months		1 year
Outcomes	MD	ES	MD	ES	MD	ES	MD	ES	MD	ES
TG	-0.57 (-7.46, 6.32)	-0.00	3.29 (-0.37, 6.96)	0.14	1.33 (-2.31, 4.97)	0.06	-1.34 (-5.09, 2.41)	-0.10	-2.34 (-6.09, 1.41)	-0.10
P value	0.869		0.078		0.471		0.482		0.220
HDL	1.42 (-0.90, 3.74)	0.18	-4.33 (-5.57, -3.09)	-0.60	-2.62 (-3.78, -1.45)	-0.40	2.09 (0.89, 3.30)	0.27	2.38 (1.22, 3.55)	0.33
P value	0.229		< 0.001^a		< 0.001^a		0.001^a		< 0.001^a
TC	1.42 (-4.04, 6.87)	0.06	-16.44 (-20.36, -12.51)	-0.70	-0.39 (-3.98, 3.19)	-0.00	-0.20 (-3.33, 2.93)	-0.00	2.74 (-0.86, 6.33)	0.12
P value	0.609		0.001^a		0.829		0.898		0.135
PG	-0.03 (-0.63, 0.58)	-0.00	-0.03 (-0.63, 0.58)	-0.00	-0.03 (-0.63, 0.58)	-0.00	-0.03 (-0.63, 0.58)	-0.00	-0.03 (-0.63, 0.58)	-0.00
P value	0.933		0.933		0.933		0.933		0.933
TX	-0.09 (-0.17, 0.00)	-0.30	-0.09 (-0.18, -0.01)	-0.30	-0.08 (-0.15, 0.01)	-0.30	-0.09 (-0.18, -0.01)	-0.30	-0.08 (-0.15, 0.01)	-0.30
P value	0.041^a		0.038^a		0.036^a		0.038^a		0.036^a

^aP < 0.05.

Values are represented as the mean difference (95% confidence interval of mean difference range). ES: Effect size HDL: High-density lipoprotein; MD: Mean difference; PG: Prostaglandin; TC: Total cholesterol; TG: Triglyceride; TX: Thromboxane.

Table 3 Interrelationships among lipid parameters and eicosanoids

Variables	Triglyceride	High-density lipoprotein	Total cholesterol	Prostaglandin	Thromboxane
Triglyceride	1
High-density lipoprotein	-0.55^a	1
Total cholesterol	0.69^a	-0.79^a	1
Prostaglandin	0.03	0.05	-0.09^a	1
Thromboxane	0.38^a	-0.29^a	0.34^a	-0.14^a	1

^aP < 0.05.

Table 4 Generalized estimating equations multiple regression analysis for triglyceride

Variables (n = 224)	Categories	Crude effect		Adjusted effect
Variables (n = 224)	Categories	β (95%CI)	P value	β (95%CI)	P value
Vaccination status	Vaccinated	0.07 (-2.76, 2.91)	0.959¹	1.46 (-1.09, 4.02)	0.263
Vaccination status	Unvaccinated	Reference		Reference
Time			< 0.00^a		< 0.00^b
	3 months	0.15 (-3.40, 3.71)	0.933	0.15 (-3.40, 3.71)	0.933
	6 months	0.35 (-3.62, 4.32)	0.862	0.35 (-3.62, 4.32)	0.862
	9 months	-0.67 (-2.84, 1.49)	0.542	-0.67 (-2.84, 1.49)	0.542
	1 year	0.07 (-2.09, 2.24)	0.948	0.07 (-2.09, 2.24)	0.948
	Base line	Reference		Reference
Group time^b					0.070
	Vaccinated 3 months			3.87 (-2.99, 10.72)	0.269
	Vaccinated 6 months			1.90 (-5.29, 9.10)	0.604
	Vaccinated 9 months			-0.77 (-6.49, 4.96)	0.793
	Vaccinated 1 year			-1.77 (-7.49, 3.96)	0.546
	Vaccinated baseline			Reference
Age group	≤ 40 years	-12.92 (-16.27, -9.57)	< 0.001^a	-13.29 (-16.70, -9.88)	< 0.001^b
Age group	> 40 years	Reference		Reference
Sex	Female	-6.40 (-10.33, -2.48)	0.001^a	-8.68 (-12.41, -4.95)	< 0.001^b
Sex	Male	Reference		Reference
Alcohol exposure	Yes	-6.38 (-10.42, -2.35)	0.002^a	-8.77 (-12.64, -4.89)	< 0.001^b
Alcohol exposure	No	Reference		Reference
Chat exposure	Yes	2.45 (-3.18, 8.09)	0.394
Chat exposure	No	Reference
Smoking exposure	Yes	3.32 (-7.28, 13.93)	0.539
Smoking exposure	No	Reference
Medications			0.003^a		0.394
	Insulin	1.16 (-4.15, 6.47)	0.668	0.79 (-3.97, 5.56)	0.745
	Metformin	7.08 (2.73, 11.44)	0.001	2.75 (-1.23, 6.72)	0.176
	Both	Reference		Reference
Intercept				167.68

^aP ≤ 0.20.

^bP < 0.05

¹Biological criteria.

95%CI: 95% confidence interval.

Table 5 Generalized estimating equations multiple regression analysis for high-density lipoprotein

Variables (n = 224)	Categories	Crude effect		Adjusted effect
Variables (n = 224)	Categories	β (95%CI)	P value	β (95%CI)	P value
Vaccination status	Vaccinated	-0.21 (-1.02, 0.59)	0.609¹	1.30 (-0.74, 3.34)	0.210
Vaccination status	Unvaccinated	Reference		Reference
Time			< 0.001^a		< 0.001^b
	3 months	-3.69 (-4.96, -2.42)	< 0.001	-2.23 (-3.74, -0.72)	0.004^b
	6 months	-2.22 (-3.55, -0.89)	0.001	-1.19 (-2.82, 0.43)	0.150
	9 months	-3.43 (-4.37, -2.49)	< 0.001	-3.60 (-4.67, -2.54)	< 0.001^b
	1 year	2.95 (--4.26, -1.64)	< 0.001	-3.19 (-4.82, -1.57)	< 0.001^b
	Baseline	Reference		Reference
Group time^b	Vaccinated 3 months			-5.75 (-8.18, -3.33)	< 0.001^b
	Vaccinated 6 months			-4.04 (-6.58, -1.49)	0.002^b
	Vaccinated 9 months			0.67 (-1.55, 2.90)	0.553
	Vaccinated 1 year			0.96 (-1.58, 3.50)	0.457
	Vaccinated baseline			Reference
Age group	≤ 40 years	2.15 (1.16, 3.14)	< 0.001^a	2.23 (1.21, 3.25)	< 0.001^b
Age group	> 40 years	Reference		Reference
Sex	Female	1.23 (0.22, 2.23)	0.017^a	1.33 (.35, 2.31)	0.008^b
Sex	Male	Reference		Reference
Alcohol exposure	Yes	-0.57 (-1.76, 0.62)	0.348
Alcohol exposure	No	Reference
Chat exposure	Yes	0.23 (-1.08, 1.53)	0.734
Chat exposure	No	Reference
Smoking exposure	Yes	0.06 (-1.41, 1.53)	0.934
Smoking exposure	No	Reference
Medications			0.081		0.749
	Insulin	0.23 (-1.19, 1.64)	0.753	0.29 (-1.08, 1.67)	0.676
	Metformin	-1.03 (-2.09, 0.03)	0.057	-0.27 (-1.36, 0.82)	0.628
	Both	Reference		Reference
Intercept				57.58

^aP ≤ 0.20.

^bP < 0.05

¹Biological criteria.

95%CI: 95% confidence interval.

Table 6 Generalized estimating equations multiple regression analysis for total cholesterol

Variables (n = 224)	Categories	Crude effect		Adjusted effect
Variables (n = 224)	Categories	β (95%CI)	P value	β (95%CI)	P value
Vaccination status	Vaccinated	-2.58 (-4.93, -0.22)	0.032^a	2.28 (-2.47, 7.04)	0.347
Vaccination status	Unvaccinated	Reference		Reference
Time			< 0.001^a		< 0.001^b
	3 months	12.42 (8.61, 16.22)	< 0.001	16.96 (12.26, 21.66)	< 0.001^b
	6 months	-0.32 (-4.08, 3.45)	0.869	0.14 (-4.71, 4.99)	0.954
	9 months	-0.19 (-1.83, 1.44)	0.814	0.22 (-1.43, 1.87)	0.798
	1 year	0.35 (-3.42, 4.12)	0.856	0.01 (-4.85, 4.87)	0.996
	Baseline	Reference		Reference
Group time^b	Vaccinated 3 months			-17.85 (-24.17, -11.53)	< 0.001b
	Vaccinated 6 months			-1.81 (-8.16, 4.54)	0.577
	Vaccinated 9 months			-1.62 (-6.16, 2.92)	0.485
	Vaccinated 1 year			1.32 (-5.04, 7.68)	0.684
	Vaccinated baseline			Reference
Age group	≤ 40 years	-6.14 (-9.43, -2.85)	< 0.001^a	-6.19 (-9.59, -2.81)	< 0.001^b
Age group	> 40 years	Reference		Reference
Sex	Female	-3.39 (-6.65, -0.56)	0.041^a	-4.90 (-8.47, -1.33)	0.007^b
Sex	Male	Reference		Reference
Alcohol exposure	Yes	-3.85 (-7.14, 0.62)	0.022^a	-5.09 (-8.65, -1.53)	0.005^b
Alcohol exposure	No	Reference		Reference
Chat exposure	Yes	0.80 (-3.48, 5.09)	0.714
Chat exposure	No	Reference
Smoking exposure	Yes	-2.99 (-6.38, 0.39)	0.083^a	-4.47 (-8.26, -0.69)	0.020^b
Smoking exposure	No	Reference		Reference
Medications			0.024^a		0.437
	Insulin	1.67 (-3.04, 6.38)	0.486	1.13 (-3.43, 5.70)	0.627
	Metformin	4.71 (1.28, 8.14)	0.007	2.26 (-1.21, 5.72)	0.202
	Both	Reference
Intercept				192.41

^aP ≤ 0.20.

^bP < 0.05

95%CI: 95% confidence interval.

Table 7 Generalized estimating equations multiple regression analysis for prostaglandin

Variables (n = 224)		Crude effect		Adjusted effect
Variables (n = 224)		β (95%CI)	P value	β (95%CI)	P value
Vaccination status	Vaccinated	-0.03 (-0.62, 0.57)	0.933¹	-0.04 (-0.56, 0.48)	0.880
Vaccination status	Unvaccinated	Reference		Reference
Age group	≤ 40 years	-0.53 (-1.07, 0.01)	0.055^a	-0.68 (-1.20, -0.17)	0.010^b
Age group	> 40 years	Reference		Reference
Sex	Female	0.83 (0.32, 1.33)	0.001^a	0.45 (-0.11, 1.01)	0.118
Sex	Male	Reference		Reference
Alcohol exposure	Yes	-0.53 (-1.17, 0.10)	0.101^a	-0.33 (-0.94, 0.27)	0.281
Alcohol exposure	No	Reference		Reference
Chat exposure	Yes	0.31 (-0.42, 1.04)	0.407
Chat exposure	No	Reference
Smoking exposure	Yes	0.58 (-1.07, 2.24)	0.488
Smoking exposure	No	Reference
Medications			0.001^a		< 0.001^b
	Insulin	-0.33 (-1.01, 0.34)	0.335	-0.37 (-1.03, 0.29)	0.278
	Metformin	-1.12 (-1.71, -0.53)	< 0.001	-1.22 (-1.79, -0.65)	< 0.001^b
	Both	Reference
Intercept				26.51

^aP ≤ 0.20.

^bP < 0.05

¹Biological criteria.

95%CI: 95% confidence interval.

Table 8 Generalized estimating equations multiple regression analysis for thromboxane

Variables (n = 224)		Crude effect		Adjusted effect
Variables (n = 224)		β (95%CI)	P value	β (95%CI)	P value
Vaccination status	Vaccinated	-0.09 (-0.16, -0.01)	0.032^a	-0.07 (-0.13, -0.01)	0.034^b
Vaccination status	Unvaccinated	Reference		Reference
Time			< 0.001^a		< 0.001^b
	3 months	0.19 (0.19, 0.20)	< 0.001	0.19 (0.19, 0.20)	< 0.001^b
	6 months	-0.19 (-0.20, -0.19)	< 0.001	-0.19 (-0.20, -0.19)	< 0.001^b
	9 months	0.29 (0.29, 0.30)	< 0.001	0.29 (0.29, 0.30)	< 0.001^b
	1 year	-0.19 (-0.20, -0.19)	< 0.001	-0.19 (-0.20, -0.19)	< 0.001^b
	Baseline	Reference		Reference
Group time^b	Vaccinated 3 months			-0.00 (-0.01, 0.00)	0.247
	Vaccinated 6 months			0.01 (-0.01, 0.02)	0.247
	Vaccinated 9 months			-0.00 (-0.01, 0.00)	0.247
	Vaccinated 1 year			0.01 (-0.01, 0.02)	0.247
	Vaccinated baseline			Reference
Age group	≤ 40 years	-0.34 (-0.39, -0.28)	< 0.001^a	-0.34 (-0.39, -0.29)	< 0.001^b
Age group	> 40 years	Reference		Reference
Sex	Female	-0.12 (-0.19, -0.04)	0.002^a	-0.13 (-0.19, -0.07)	< 0.001^b
Sex	Male	Reference		Reference
Alcohol exposure	Yes	-0.02 (-0.11, 0.07)	0.706
Alcohol exposure	No	Reference
Chat exposure	Yes	-0.01 (-0.14, 0.12)	0.885
Chat exposure	No	Reference
Smoking exposure	Yes	-0.02 (-0.19, 0.16)	0.853
Smoking exposure	No	Reference
Medications			< 0.001^a		0.222
	Insulin	0.07 (-0.01, 0.16)	0.094	0.05 (-0.02, 0.12)	0.139
	Metformin	0.16 (0.08, 0.24)	< 0.001	0.05 (-0.02, 0.13)	0.151
	Both	Reference
Intercept				1.29

^aP ≤ 0.20.

^bP < 0.05

¹Biological criteria.

95%CI: 95% confidence interval.

Citation: Edae CK, Bedada AT, Teklemariam MD, Girma T, Gebre SG. Longitudinal effects of Johnson & Johnson COVID-19 vaccination on metabolic biomarkers in type 2 diabetes mellitus in Ethiopia. World J Diabetes 2025; 16(6): 105447
URL: https://www.wjgnet.com/1948-9358/full/v16/i6/105447.htm
DOI: https://dx.doi.org/10.4239/wjd.v16.i6.105447