Association between inflammatory biomarkers and incident type 2 diabetes mellitus: The western New York study
Rafalson Dreishpoon, Lisa
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Objective. To report the incidence of Type 2 diabetes mellitus (T2DM), and to investigate whether two inflammatory biomarkers, C-reactive protein (CRP) and interleukin-6 (IL-6), are associated with the development of T2DM. Methods. 1455 participants from the Western New York Health Study (response rate 68%) who at baseline (1996-2001) were 35-79 years (mean age 59) and free of T2DM and self-reported cardiovascular disease. Diabetes was defined as a fasting glucose exceeding 125 mg/dl or on antidiabetic medication at the follow-up exam: 69 cases were identified and individually matched with 3 controls on the basis of sex, race, year of study enrollment, and baseline fasting glucose (<110 or 110-125 mg/dl). Results. Over a mean follow-up of 6.2 years, the incidence of T2DM was 8.02 (95% CI: 6.16-10.12) per 1000 person-years. Compared to controls, cases were significantly heavier (BMI 32.2 kg/m 2 vs. 29.2 kg/m 2 ,P=0.001), more hyperinsulinemic (22 uU/ml vs. 11.8 uU/ml, P<0.05) and more often reported a family history of diabetes(55.2% vs. 39.9%, P<0.05). Median CRP was higher among cases than controls (4.4 ug/ml vs.3.2 ug/ml, P=0.018). Median IL-6 was higher in cases, 2.89 pg/ml, than controls, 2.45 pg/ml (P<0.001). In conditional logistic regression analyses the age-adjusted OR of T2DM for persons with elevated CRP (> median vs. < median) was 2.5 (95%: CI 1.22-4.95; P=0.012). Fully adjusted for family history of diabetes, smoking, drinking status, physical activity, and BMI the OR for elevated CRP was markedly attenuated1.49 (95% CI: 0.67-3.33; P=0.331). The age adjusted OR of T2DM for elevated IL-6 (> median vs. < median) was 1.33 (95% CI: 0.72-2.46; P=0.368). Fully adjusted the OR was 0.75 (95% CI: 0.36-1.54; P=0.424). Conclusion. Neither biomarker was a significant, independent predictor of incident T2DM after considering other risk factors that have been associated with T2DM.