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Association of changes in inflammation with variation in glycaemia, insulin resistance and secretion based on the KORA study

de las Heras Gala, Tonia ; Herder, Christian ; Rutters, Femke ; Carstensen-Kirberg, Maren ; Huth, Cornelia ; Stehouwer, Coen D.A. ; Nijpels, Giel ; Schalkwijk, Casper ; Flyvbjerg, Allan and Franks, Paul W. LU , et al. (2018) In Diabetes/Metabolism Research and Reviews 34(8).
Abstract

Aims: Subclinical systemic inflammation may contribute to the development of type 2 diabetes, but its association with early progression of glycaemic deterioration in persons without diabetes has not been fully investigated. Our primary aim was to assess longitudinal associations of changes in pro-inflammatory (leukocytes, high-sensitivity C-reactive protein (hsCRP)) and anti-inflammatory (adiponectin) markers with changes in markers that assessed glycaemia, insulin resistance, and secretion (HbA1c, HOMA-IR, and HOMA-ß). Furthermore, we aimed to directly compare longitudinal with cross-sectional associations. Materials and methods: This study includes 819 initially nondiabetic individuals with repeated measurements from the... (More)

Aims: Subclinical systemic inflammation may contribute to the development of type 2 diabetes, but its association with early progression of glycaemic deterioration in persons without diabetes has not been fully investigated. Our primary aim was to assess longitudinal associations of changes in pro-inflammatory (leukocytes, high-sensitivity C-reactive protein (hsCRP)) and anti-inflammatory (adiponectin) markers with changes in markers that assessed glycaemia, insulin resistance, and secretion (HbA1c, HOMA-IR, and HOMA-ß). Furthermore, we aimed to directly compare longitudinal with cross-sectional associations. Materials and methods: This study includes 819 initially nondiabetic individuals with repeated measurements from the Cooperative Health Research in the Region of Augsburg (KORA) S4/F4 cohort study (median follow-up: 7.1 years). Longitudinal and cross-sectional associations were simultaneously examined using linear mixed growth models. Changes in markers of inflammation were used as independent and changes in markers of glycaemia/insulin resistance/insulin secretion as dependent variables. Models were adjusted for age, sex, major lifestyle and metabolic risk factors for diabetes using time-varying variables in the final model. Results: Changes of leukocyte count were positively associated with changes in HbA1c and HOMA-ß while changes in adiponectin were inversely associated with changes in HbA1c. All examined cross-sectional associations were statistically significant; they were generally stronger and mostly directionally consistent to the longitudinal association estimates. Conclusions: Adverse changes in low-grade systemic inflammation go along with glycaemic deterioration and increased insulin secretion independently of changes in other risk factors, suggesting that low-grade inflammation may contribute to the development of hyperglycaemia and a compensatory increase in insulin secretion.

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published
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keywords
glycaemic deterioration, HbA, inflammation, insulin resistance, ß-cell function
in
Diabetes/Metabolism Research and Reviews
volume
34
issue
8
article number
e3063
publisher
John Wiley & Sons
external identifiers
  • pmid:30114727
  • scopus:85054309122
ISSN
1520-7552
DOI
10.1002/dmrr.3063
language
English
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yes
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fce6f9fa-bc98-486b-bd03-07775837df08
date added to LUP
2018-11-13 12:39:53
date last changed
2020-01-16 03:36:45
@article{fce6f9fa-bc98-486b-bd03-07775837df08,
  abstract     = {<p>Aims: Subclinical systemic inflammation may contribute to the development of type 2 diabetes, but its association with early progression of glycaemic deterioration in persons without diabetes has not been fully investigated. Our primary aim was to assess longitudinal associations of changes in pro-inflammatory (leukocytes, high-sensitivity C-reactive protein (hsCRP)) and anti-inflammatory (adiponectin) markers with changes in markers that assessed glycaemia, insulin resistance, and secretion (HbA<sub>1c</sub>, HOMA-IR, and HOMA-ß). Furthermore, we aimed to directly compare longitudinal with cross-sectional associations. Materials and methods: This study includes 819 initially nondiabetic individuals with repeated measurements from the Cooperative Health Research in the Region of Augsburg (KORA) S4/F4 cohort study (median follow-up: 7.1 years). Longitudinal and cross-sectional associations were simultaneously examined using linear mixed growth models. Changes in markers of inflammation were used as independent and changes in markers of glycaemia/insulin resistance/insulin secretion as dependent variables. Models were adjusted for age, sex, major lifestyle and metabolic risk factors for diabetes using time-varying variables in the final model. Results: Changes of leukocyte count were positively associated with changes in HbA<sub>1c</sub> and HOMA-ß while changes in adiponectin were inversely associated with changes in HbA<sub>1c</sub>. All examined cross-sectional associations were statistically significant; they were generally stronger and mostly directionally consistent to the longitudinal association estimates. Conclusions: Adverse changes in low-grade systemic inflammation go along with glycaemic deterioration and increased insulin secretion independently of changes in other risk factors, suggesting that low-grade inflammation may contribute to the development of hyperglycaemia and a compensatory increase in insulin secretion.</p>},
  author       = {de las Heras Gala, Tonia and Herder, Christian and Rutters, Femke and Carstensen-Kirberg, Maren and Huth, Cornelia and Stehouwer, Coen D.A. and Nijpels, Giel and Schalkwijk, Casper and Flyvbjerg, Allan and Franks, Paul W. and Dekker, Jacqueline and Meisinger, Christa and Koenig, Wolfgang and Roden, Michael and Rathmann, Wolfgang and Peters, Annette and Thorand, Barbara},
  issn         = {1520-7552},
  language     = {eng},
  number       = {8},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research and Reviews},
  title        = {Association of changes in inflammation with variation in glycaemia, insulin resistance and secretion based on the KORA study},
  url          = {http://dx.doi.org/10.1002/dmrr.3063},
  doi          = {10.1002/dmrr.3063},
  volume       = {34},
  year         = {2018},
}