C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study

Freeman, D.J. , Norrie, J., Caslake, M.J., Gaw, A., Ford, I. , Lowe, G.D.O., O'Reilly, D.S., Packard, C.J. and Sattar, N. (2002) C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes, 51(5), pp. 1596-1600.

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Publisher's URL: http://diabetes.diabetesjournals.org/cgi/content/full/51/5/1596

Abstract

Accumulating evidence implicates inflammation as a potential pathway in the pathogenesis of type 2 diabetes. The objective of the present study was to assess the ability of C-reactive protein (CRP) to predict the development of diabetes in middle-aged men in the West of Scotland Coronary Prevention Study. Baseline plasma samples for CRP measurement were available for 5,245 men of whom 127 were classified as having a transition from normal glucose control to overt diabetes during the study, based on American Diabetes Association criteria. Baseline CRP was an important predictor of the development of diabetes in univariate analysis (hazard ratio [HR] for an increase of 1 SD = 1.55; 95% CI 1.32-1.82; P lt 0.0001). In multivariate analysis, CRP remained a predictor of diabetes development (HR 1.30; 95% Cl 1.07-1.58; P = 0.0075) independent of other clinically employed predictors, including baseline BMI and fasting triglyceride and glucose concentrations. Moreover, there was a graded increase in risk across CRP quintiles throughout the study, evident at even 1 year of follow-up. The highest quintile (CRP gt 4.18 mg/l) was associated with a greater than threefold risk of developing diabetes (HR 3.07; 95% Cl 1.33-7.10) in a multivariate analysis at 5 years. Thus, CRP predicts the development of type 2 diabetes in middle-aged men independently of established risk factors. Because CRP, the most commonly used acute-phase protein in clinical practice, is very stable in serum, our observations have clinical potential in helping to better predict individuals destined to develop type 2 diabetes. They also add to the notion that low-grade inflammation is important in the pathogenesis of type 2 diabetes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gaw, Dr Allan and Norrie, Prof John and Caslake, Professor Muriel and Freeman, Dr Dilys and Packard, Professor Chris and O'Reilly, Dr Denis and Sattar, Professor Naveed and Ford, Professor Ian and Lowe, Professor Gordon
Authors: Freeman, D.J., Norrie, J., Caslake, M.J., Gaw, A., Ford, I., Lowe, G.D.O., O'Reilly, D.S., Packard, C.J., and Sattar, N.
Subjects:R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetes
ISSN:0012-1797

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