Positive association between high-sensitivity C-reactive protein and incidence of type 2 diabetes mellitus in Japanese workers: 6-year follow-up

Chaochen Wang, Hiroshi Yatsuya, Koji Tamakoshi, Mayu Uemura, Yuanying Li, Keiko Wada, Kentaro Yamashita, Leo Kawaguchi, Hideaki Toyoshima, Atsuko Aoyama

Research output: Contribution to journalArticle

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Abstract

Background: Elevated high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade systemic inflammation, may be involved in the etiology of type 2 diabetes mellitus (T2DM). However, whether inflammation precedes development of T2DM independent of cigarette smoking and obesity remains to be confirmed. Methods: We studied 4213 civil servants in a local government in Japan aged 35-66years at baseline in 2002, who donated blood samples and were followed 6years. Hazard ratios (HR) of T2DM according to the hs-CRP quartiles [range Q1: 0.02-0.18 (reference), Q2: 0.18-0.33, Q3: 0.33-0.67 and Q4: 0.67-9.62mg/L) were estimated by Cox proportional hazards model adjusted for gender, age, body mass index, alcohol intake, smoking status (current, past and never), number of cigarettes per day, physical activity, family history of diabetes (Model 1) and variables in Model 1+glucose (Model 2). Results: The geometric mean [95% confidence interval (CI)] of hs-CRP was 0.36mg/L (0.34-0.37). During the follow-up, 156 new T2DM cases were confirmed. In total sample, Model 2 HRs (95% CIs) for hs-CRP quartiles Q2-Q4 compared with Q1 were 0.69 (0.36-1.26), 1.47 (0.91-2.39) and 1.78 (1.10-2.88), respectively (p for linear trend=0.014). Stratified analysis revealed that a statistically significant association was observed only in normal weight non-current smokers with Model 2 HRs (CIs) being 0.79 (0.29-2.17), 2.63 (1.25-5.56) and 3.19 (1.49-6.86) for Q2-Q4 compared with Q1, respectively (p for linear trend=0.0006). The relationship did not change materially after further adjusting for log-homeostasis model assessment or exclusion of past smokers. Conclusions: These findings imply that higher hs-CRP itself or existence of chronic systemic inflammation precedes onset of T2DM independent of obesity and smoking.

Original languageEnglish
Pages (from-to)398-405
Number of pages8
JournalDiabetes/Metabolism Research and Reviews
Volume29
Issue number5
DOIs
Publication statusPublished - 01-07-2013

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C-Reactive Protein
Type 2 Diabetes Mellitus
Incidence
Smoking
Inflammation
Obesity
Local Government
Proportional Hazards Models
Tobacco Products
Japan
Body Mass Index
Homeostasis
Alcohols
Confidence Intervals
Exercise
Weights and Measures
Glucose

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Wang, Chaochen ; Yatsuya, Hiroshi ; Tamakoshi, Koji ; Uemura, Mayu ; Li, Yuanying ; Wada, Keiko ; Yamashita, Kentaro ; Kawaguchi, Leo ; Toyoshima, Hideaki ; Aoyama, Atsuko. / Positive association between high-sensitivity C-reactive protein and incidence of type 2 diabetes mellitus in Japanese workers : 6-year follow-up. In: Diabetes/Metabolism Research and Reviews. 2013 ; Vol. 29, No. 5. pp. 398-405.
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abstract = "Background: Elevated high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade systemic inflammation, may be involved in the etiology of type 2 diabetes mellitus (T2DM). However, whether inflammation precedes development of T2DM independent of cigarette smoking and obesity remains to be confirmed. Methods: We studied 4213 civil servants in a local government in Japan aged 35-66years at baseline in 2002, who donated blood samples and were followed 6years. Hazard ratios (HR) of T2DM according to the hs-CRP quartiles [range Q1: 0.02-0.18 (reference), Q2: 0.18-0.33, Q3: 0.33-0.67 and Q4: 0.67-9.62mg/L) were estimated by Cox proportional hazards model adjusted for gender, age, body mass index, alcohol intake, smoking status (current, past and never), number of cigarettes per day, physical activity, family history of diabetes (Model 1) and variables in Model 1+glucose (Model 2). Results: The geometric mean [95{\%} confidence interval (CI)] of hs-CRP was 0.36mg/L (0.34-0.37). During the follow-up, 156 new T2DM cases were confirmed. In total sample, Model 2 HRs (95{\%} CIs) for hs-CRP quartiles Q2-Q4 compared with Q1 were 0.69 (0.36-1.26), 1.47 (0.91-2.39) and 1.78 (1.10-2.88), respectively (p for linear trend=0.014). Stratified analysis revealed that a statistically significant association was observed only in normal weight non-current smokers with Model 2 HRs (CIs) being 0.79 (0.29-2.17), 2.63 (1.25-5.56) and 3.19 (1.49-6.86) for Q2-Q4 compared with Q1, respectively (p for linear trend=0.0006). The relationship did not change materially after further adjusting for log-homeostasis model assessment or exclusion of past smokers. Conclusions: These findings imply that higher hs-CRP itself or existence of chronic systemic inflammation precedes onset of T2DM independent of obesity and smoking.",
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Positive association between high-sensitivity C-reactive protein and incidence of type 2 diabetes mellitus in Japanese workers : 6-year follow-up. / Wang, Chaochen; Yatsuya, Hiroshi; Tamakoshi, Koji; Uemura, Mayu; Li, Yuanying; Wada, Keiko; Yamashita, Kentaro; Kawaguchi, Leo; Toyoshima, Hideaki; Aoyama, Atsuko.

In: Diabetes/Metabolism Research and Reviews, Vol. 29, No. 5, 01.07.2013, p. 398-405.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Positive association between high-sensitivity C-reactive protein and incidence of type 2 diabetes mellitus in Japanese workers

T2 - 6-year follow-up

AU - Wang, Chaochen

AU - Yatsuya, Hiroshi

AU - Tamakoshi, Koji

AU - Uemura, Mayu

AU - Li, Yuanying

AU - Wada, Keiko

AU - Yamashita, Kentaro

AU - Kawaguchi, Leo

AU - Toyoshima, Hideaki

AU - Aoyama, Atsuko

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background: Elevated high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade systemic inflammation, may be involved in the etiology of type 2 diabetes mellitus (T2DM). However, whether inflammation precedes development of T2DM independent of cigarette smoking and obesity remains to be confirmed. Methods: We studied 4213 civil servants in a local government in Japan aged 35-66years at baseline in 2002, who donated blood samples and were followed 6years. Hazard ratios (HR) of T2DM according to the hs-CRP quartiles [range Q1: 0.02-0.18 (reference), Q2: 0.18-0.33, Q3: 0.33-0.67 and Q4: 0.67-9.62mg/L) were estimated by Cox proportional hazards model adjusted for gender, age, body mass index, alcohol intake, smoking status (current, past and never), number of cigarettes per day, physical activity, family history of diabetes (Model 1) and variables in Model 1+glucose (Model 2). Results: The geometric mean [95% confidence interval (CI)] of hs-CRP was 0.36mg/L (0.34-0.37). During the follow-up, 156 new T2DM cases were confirmed. In total sample, Model 2 HRs (95% CIs) for hs-CRP quartiles Q2-Q4 compared with Q1 were 0.69 (0.36-1.26), 1.47 (0.91-2.39) and 1.78 (1.10-2.88), respectively (p for linear trend=0.014). Stratified analysis revealed that a statistically significant association was observed only in normal weight non-current smokers with Model 2 HRs (CIs) being 0.79 (0.29-2.17), 2.63 (1.25-5.56) and 3.19 (1.49-6.86) for Q2-Q4 compared with Q1, respectively (p for linear trend=0.0006). The relationship did not change materially after further adjusting for log-homeostasis model assessment or exclusion of past smokers. Conclusions: These findings imply that higher hs-CRP itself or existence of chronic systemic inflammation precedes onset of T2DM independent of obesity and smoking.

AB - Background: Elevated high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade systemic inflammation, may be involved in the etiology of type 2 diabetes mellitus (T2DM). However, whether inflammation precedes development of T2DM independent of cigarette smoking and obesity remains to be confirmed. Methods: We studied 4213 civil servants in a local government in Japan aged 35-66years at baseline in 2002, who donated blood samples and were followed 6years. Hazard ratios (HR) of T2DM according to the hs-CRP quartiles [range Q1: 0.02-0.18 (reference), Q2: 0.18-0.33, Q3: 0.33-0.67 and Q4: 0.67-9.62mg/L) were estimated by Cox proportional hazards model adjusted for gender, age, body mass index, alcohol intake, smoking status (current, past and never), number of cigarettes per day, physical activity, family history of diabetes (Model 1) and variables in Model 1+glucose (Model 2). Results: The geometric mean [95% confidence interval (CI)] of hs-CRP was 0.36mg/L (0.34-0.37). During the follow-up, 156 new T2DM cases were confirmed. In total sample, Model 2 HRs (95% CIs) for hs-CRP quartiles Q2-Q4 compared with Q1 were 0.69 (0.36-1.26), 1.47 (0.91-2.39) and 1.78 (1.10-2.88), respectively (p for linear trend=0.014). Stratified analysis revealed that a statistically significant association was observed only in normal weight non-current smokers with Model 2 HRs (CIs) being 0.79 (0.29-2.17), 2.63 (1.25-5.56) and 3.19 (1.49-6.86) for Q2-Q4 compared with Q1, respectively (p for linear trend=0.0006). The relationship did not change materially after further adjusting for log-homeostasis model assessment or exclusion of past smokers. Conclusions: These findings imply that higher hs-CRP itself or existence of chronic systemic inflammation precedes onset of T2DM independent of obesity and smoking.

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