Dataset Information

The trajectory of high sensitivity C-reactive protein is associated with incident diabetes in Chinese adults.

ABSTRACT:

Background

We performed a cohort study to evaluate the association between the CRP trajectory and incident diabetes in Chinese adults.

Methods

Included were 6439 adults (4111 men and 2249 women; aged 46.6 ± 11.9 years). The concentration of high sensitivity CRP (hs-CRP) was measured in 2013 (baseline), 2014, and 2015. The hs-CRP trajectory was identified based the above three measurements by latent mixture modeling. Incident diabetes cases were diagnosed by fasting blood glucose (≥126 mg/dl) or Hb A1c (≥6.5%) during subsequent 3 years (2016-2018).

Results

Hs-CRP concentration during 2013-2015 was classified into 3 levels: low (< 1.0 mg/L), moderate (1.0-3.0 mg/L), and high (≥3.0 mg/L) based on a statement by American Heart Association. We named four hs-CRP trajectories as following: "low-stable" (low in 2013 and maintained at low concentration in 2014 and 2015), "moderate-fluctuated" (moderate in 2013, then increased to high concentration in 2014, and decreased to low concentration in 2015), "high-decreased" (high in 2013 but decreased to moderate concentration in 2014 and 2015), and "moderate-increased (moderate in 2013 and increased to high concentration in 2014 and 2015)". We identified 235 incident diabetes during subsequent 3 years. The adjusted HR for incident diabetes was 1.71 (95% CI: 1.02, 2.87) comparing the moderate-increased and the low-stable group, after adjusting for potential confounders. In the secondary analyses, two single-measured hs-CRP concentration (in 2013 or in 2015) and the average of hs-CRP were associated with high risk of diabetes (P-trend< 0.01 for all).

Conclusions

The hs-CRP trajectory pattern was associated with altered incident diabetes in Chinese adults.

SUBMITTER: Xu R

PROVIDER: S-EPMC7325292 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

The trajectory of high sensitivity C-reactive protein is associated with incident diabetes in Chinese adults.

Xu Renying R Jiang Xiaomin X Fan Zhuping Z Wan Yanping Y Gao Xiang X

Nutrition & metabolism 20200630

<h4>Background</h4>We performed a cohort study to evaluate the association between the CRP trajectory and incident diabetes in Chinese adults.<h4>Methods</h4>Included were 6439 adults (4111 men and 2249 women; aged 46.6 ± 11.9 years). The concentration of high sensitivity CRP (hs-CRP) was measured in 2013 (baseline), 2014, and 2015. The hs-CRP trajectory was identified based the above three measurements by latent mixture modeling. Incident diabetes cases were diagnosed by fasting blood glucose ( ...[more]

PMID: 32612667

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Project description:BackgroundThe atherogenic index of plasma (AIP) and systematic inflammation, as measured by high-sensitivity C-reactive protein (hsCRP), are predictors of diabetes, but their combined impacts on incident diabetes are poorly understood. Using a nationally representative cohort in China, we aimed to investigate the association of AIP and hsCRP with incident diabetes among middle-aged and elderly adults.MethodsThis cohort comprised 9,112 participants aged at least 45 years from 125 cities in the China Health and Retirement Longitudinal Study who were free of diabetes at baseline in 2011. Of these, 5,048 participants were followed up until 2015. The AIP was calculated as Log10[TG (mg/dL)/HDL-C(mg/dL)]. Multivariate logistic regression and linear mixed-effect (LME) models were performed to evaluate the associations of AIP, hsCRP, and incident diabetes as well as glycemic biomarkers. Receiver operating characteristic (ROC) curves were used to evaluate their diagnostic values. We conducted a mediation analysis to assess the direct and indirect associations between AIP and hsCRP with diabetes.Results489 (9.7%) cases developed diabetes during four years. Higher levels of AIP and hsCRP were independently associated with diabetes. Compared to the lowest quartile of AIP or hsCRP, the highest quartile of AIP (adjusted odds ratio, aOR 2.53, 95% CI: 1.90-3.38) and hsCRP (aOR 2.38, 1.79-3.16) was significantly associated with incident diabetes. The joint effects showed that participants with higher levels of AIP and hsCRP had significantly higher aOR of 2.76 (2.13-3.57). The LME models showed AIP and hsCRP were related to an increased level of fasting blood glucose and glycated hemoglobin. The combination of AIP and hsCRP has better predictive efficacy (area under the curve, AUC: 0.628, 0.601-0.654) for incident diabetes than alone. Mediation analyses showed that high AIP significantly mediated 25.4% of the association between hsCRP and diabetes, and hsCRP simultaneously mediated 5.7% of the association between AIP and diabetes.ConclusionsThis cohort suggests combined effects and mutual mediation between the AIP and hsCRP on incident diabetes in China. Our findings provide clinical implications for monitoring and managing AIP and hsCRP levels to mitigate the development of diabetes.

Project description:BackgroundHigh-sensitivity C-reactive protein (hs-CRP) is an inflammatory marker that has been suggested as a predictor of cardiovascular diseases. High glycated hemoglobin (HbA1c) levels and overweight/obesity are independently associated with elevated hs-CRP; meanwhile, high HbA1c levels are frequently accompanied by overweight or obesity. However, their joint effect on elevated hs-CRP levels has not been well-established. Therefore, we evaluated whether overweight/obesity modified the association between high HbA1c levels and elevated hs-CRP.MethodsBased on cross-sectional data from the Chinese Urban Adults Diet and Health Study (CUADHS) in 2016, we included 1,630 adults aged 18-75 years (mean age 50.16 years and 33.6% male). Elevated hs-CRP was defined as serum hs-CRP ≥ 3 and <10 mg/L. The interactive effects of BMI and HbA1c levels on the risk of elevated hs-CRP levels were calculated by using multiple logistic regression models, followed by strata-specific analyses.ResultsIndividuals with elevated hs-CRP had a higher rate of HbA1c level than those without elevated (25.3 vs. 11.3%, P < 0.001), as well as a higher rate of overweight/obesity (67.1 vs. 43.5%, P < 0.001). Higher HbA1c levels were independently associated with an increased risk of elevated hs-CRP [adjusted odds ratio (aOR) = 2.31, 95% confidence interval (CI): 1.47, 3.65], as well as overweight/obesity with the risk of elevated hs-CRP (aOR = .31, 95% confidenc-3.73). Furthermore, overweight/obesity showed a significant synergistic effect on high HbA1c levels with a higher aOR of 5.25 (2.77, 9.95) (Pinteraction < 0.001). This synergistic effect was more prominent when stratified by age (in 18-44 years old, aOR, 95% CI = 30.90, 4.40-236.47 for interaction vs. 6.46, 1.38-30.23 for high HbA1c only) and gender (in women, aOR, 95% CI = 8.33, 3.80-18.23 for interaction vs. 2.46,1.38-4.40 for high HbA1c only).ConclusionThere are synergistic effects of high HbA1c levels and overweight/obesity on the risk of elevated hs-CRP in Chinese adults, with more significant effects in adults aged 18-44 years or females. Intervention strategies for preventing high blood glucose levels and body weight simultaneously may be important for reducing hs-CRP-related diseases. Further studies are needed to confirm this finding in other populations, and its molecular mechanisms need to be elucidated.

Dataset Information

The trajectory of high sensitivity C-reactive protein is associated with incident diabetes in Chinese adults.

Background

Methods

Results

Conclusions

Publications

The trajectory of high sensitivity C-reactive protein is associated with incident diabetes in Chinese adults.

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