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Diabetologia
Published in: Diabetologia 10/2015

01-10-2015 | Article

Association of subclinical inflammation with deterioration of glycaemia before the diagnosis of type 2 diabetes: the KORA S4/F4 study

Authors: Birgit Klüppelholz, Barbara Thorand, Wolfgang Koenig, Tonia de las Heras Gala, Christa Meisinger, Cornelia Huth, Guido Giani, Paul W. Franks, Michael Roden, Wolfgang Rathmann, Annette Peters, Christian Herder

Published in: Diabetologia | Issue 10/2015

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Abstract

Aims/hypothesis

The role of biomarkers of subclinical inflammation in the early deterioration of glycaemia before type 2 diabetes is largely unknown. We hypothesised that increased levels of circulating proinflammatory biomarkers and decreased circulating adiponectin would be associated with 7 year increases of HbA1c in non-diabetic individuals.

Methods

This study was based on individuals who participated in the prospective Cooperative Health Research in the Region of Augsburg (KORA) S4 survey (1999–2001) and the 7 year follow-up KORA F4 (2006–2008) survey. Individuals with type 2 diabetes at baseline or with a diagnosis of diabetes in the period between both surveys were excluded, which left a sample of 850 men and women. Multivariable linear regression analyses were performed to assess associations among baseline values of leucocyte count and levels of acute-phase proteins (high-sensitivity C-reactive protein [hsCRP], serum amyloid A [SAA] and fibrinogen), IL-6 and adiponectin with changes in HbA1c between baseline and follow-up.

Results

A high leucocyte count and high hsCRP, SAA and IL-6 levels were positively associated with changes in HbA1c after adjusting for age, sex, lifestyle factors and baseline HbA1c. In contrast, the adiponectin level was inversely associated with changes in HbA1c (p value between <0.0001 and 0.020). The associations of leucocyte count and levels of hsCRP and SAA with HbA1c changes remained significant after additional adjustment for waist circumference and circulating lipids at baseline and for the 7 year change in waist circumference (p value between 0.004 and 0.045).

Conclusions/interpretation

An elevated leucocyte count and elevated hsCRP and SAA were associated with early deterioration of glycaemia before the diagnosis of type 2 diabetes. These associations were largely independent of baseline abdominal adiposity and increases in waist circumference.
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Metadata
Title
Association of subclinical inflammation with deterioration of glycaemia before the diagnosis of type 2 diabetes: the KORA S4/F4 study
Authors
Birgit Klüppelholz
Barbara Thorand
Wolfgang Koenig
Tonia de las Heras Gala
Christa Meisinger
Cornelia Huth
Guido Giani
Paul W. Franks
Michael Roden
Wolfgang Rathmann
Annette Peters
Christian Herder
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 10/2015
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-015-3679-4

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