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Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study.

TitleLow-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2003
AuthorsDuncan BB, Schmidt M I, Pankow JS, Ballantyne CM, Couper D, Vigo A, Hoogeveen R, Folsom AR, Heiss G
Corporate AuthorsAtherosclerosis Risk in Communities Study
JournalDiabetes
Volume52
Issue7
Pagination1799-805
Date Published2003 Jul
ISSN0012-1797
KeywordsAfrican Continental Ancestry Group, Blood Glucose, Case-Control Studies, Cohort Studies, Diabetes Mellitus, Type 2, European Continental Ancestry Group, Female, Humans, Incidence, Inflammation, Male, Middle Aged, Reference Values, Risk Factors, Smoking, United States
Abstract

To examine the association of low-grade systemic inflammation with diabetes, as well as its heterogeneity across subgroups, we designed a case-cohort study representing the approximately 9-year experience of 10,275 Atherosclerosis Risk in Communities Study participants. Analytes were measured on stored plasma of 581 incident cases of diabetes and 572 noncases. Statistically significant hazard ratios of developing diabetes for those in the fourth (versus first) quartile of inflammation markers, adjusted for age, sex, ethnicity, study center, parental history of diabetes, and hypertension, ranged from 1.9 to 2.8 for sialic acid, orosomucoid, interleukin-6, and C-reactive protein. After additional adjustment for BMI, waist-to-hip ratio, and fasting glucose and insulin, only the interleukin-6 association remained statistically significant (HR = 1.6, 1.01-2.7). Exclusion of GAD antibody-positive individuals changed associations minimally. An overall inflammation score based on these four markers plus white cell count and fibrinogen predicted diabetes in whites but not African Americans (interaction P = 0.005) and in nonsmokers but not smokers (interaction P = 0.13). The fully adjusted hazard ratio comparing white nonsmokers with score extremes was 3.7 (P for linear trend = 0.008). In conclusion, a low-grade inflammation predicts incident type 2 diabetes. The association is absent in smokers and African-Americans.

DOI10.2337/diabetes.52.7.1799
Alternate JournalDiabetes
PubMed ID12829649
Grant List5R01-DK56918-03 / DK / NIDDK NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States