The Relation of Markers of Inflammation to the Development of Glucose Disorders in the Elderly

Abstract

Several studies suggest that inflammation plays a role in the pathogenesis of some glucose disorders in adults. We tested this hypothesis in a longitudinal cohort study of older individuals who had normal fasting glucose (FG) values at baseline. We compared the baseline levels of six inflammatory markers in participants who had developed glucose disorders at follow-up with those of participants whose FG remained normal at follow-up. Participants were members of the Cardiovascular Health Study, a prospective study of risk factors for cardiovascular disease in adults >65 years. All 5,888 participants had baseline testing, including FG and markers of inflammation: white blood cell and platelet counts and albumin, fibrinogen, C-reactive protein (CRP), and factor VIIIc levels. I t has been proposed that inflammation plays a role in the pathogenesis of some glucose disorders in adults. This hypothesis is based on four lines of evidence. First, a subset of nonobese adults without antecedent glucose abnormalities rapidly develop incident diabetes. Islet cell antibodies and antibodies to glutamic acid decarboxylase-both markers of autoimmune inflammation against the ␤-cell-occasionally are present (1-3). Second, in cross-sectional studies, markers of inflammation are elevated in those with diabetes compared with those without diabetes (4,5). In two longitudinal studies, baseline levels of certain inflammatory markers predicted incident diabetes in nondiabetic individuals (6,7). Third, mediators of inflammation, such as tumor necrosis factor ␣ (which often are present before diabetes), decrease insulin sensitivity, possibly helping to precipitate diabetes (8 -10). Last, inflammation has been implicated as part of the insulin resistance syndrome (11,12).In this report, we examine the prospective relationship between baseline markers of inflammation and worsening glucose status during a period of 3-4 years. The study population is a cohort of adults who are Ն65 years and members of the Cardiovascular Health Study (CHS), an ongoing observational study of risk factors for cardiovascular disease (CVD). We tested the hypothesis that individuals with normal fasting glucose (FG) at baseline, who had impaired fasting glucose (IFG) or diabetes at followup, had elevated levels of six inflammatory markers at baseline. RESEARCH DESIGN AND METHODSRecruitment methods for the CHS have been previously published (13). A random sample of individuals from Medicare eligibility lists were invited to participate in the study. Potential participants were excluded if they were institutionalized or confined to a wheelchair in the home or had a severe illness that was expected to lead to early death. Participants were recruited in two phases. In the first, 5,201 eligible men and women (4,926 [94.7%] other) were recruited (black cohort). The analyses done for this study are based on the updated CHS database, which incorporates minor corrections through June 1999. All participants signed consent forms upon entry into the study. Baseline examination...

Apolipoprotein B: a predictor of inflammatory status in postmenopausal overweight and obese women

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Association of C-reactive protein with type 2 diabetes: prospective analysis and meta-analysis

“…There is heterogeneity between studies, with some demonstrating an independently positive association of CRP with incident diabetes [3][4][5][6][7][8][9][10][11], while others show no association after adjustment for adiposity and insulin resistance [12][13][14][15]. Differences in the association between CRP and diabetes by sex have also been reported [16][17][18].…”

Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study

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