Changes in C-reactive protein levels before type 2 diabetes and cardiovascular death: the Whitehall II study

Tabak, A. G., Kivimaki, M., Brunner, E. J., Lowe, G.D., Jokela, M., Akbaraly, T. N., Singh-Manoux, A., Ferrie, J. E. and Witte, D. R. (2010) Changes in C-reactive protein levels before type 2 diabetes and cardiovascular death: the Whitehall II study. European Journal of Endocrinology, 163(1), pp. 89-95. (doi: 10.1530/EJE-10-0277)

Abstract

Objective: Prospective studies show that high C-reactive protein (CRP) levels predict diabetes and cardiovascular disease (CVD), but changes in this marker preceding disease onset are not well characterized. This study describes CRP trajectories prior to type 2 diabetes onset and fatal CVD. Methods: In a prospective cohort of 7350 British civil servants (70% male, mean age 51 years), 558 incident type 2 diabetes cases (75-g oral glucose tolerance test, doctor's diagnosis, or self-report) and 125 certified fatal cardiovascular events were observed during a median follow-up of >14 years. Trajectories of logarithmically transformed CRP levels prior to incident diabetes or fatal cardiovascular event (cases), or the end of follow-up (controls) were calculated using multilevel modeling. Results: Baseline CRP levels were higher among participants who developed diabetes (median (interquartile range) 1.44 (2.39) vs 0.78 (1.21) mg/l) or fatal CVD (1.49 (2.47) vs 0.84 (1.30) mg/l) compared with controls (both P<0.0001). In models adjusted for age, sex, body mass index, ethnicity, and employment grade, CRP levels increased with time among both incident diabetes cases and controls (P<0.0001), but this increase was less steep for cases group (P<0.05). CRP levels followed increasing linear trajectories in fatal cardiovascular cases and controls (P<0.0001) with no slope difference between the groups. Conclusions: CRP levels were higher among those who subsequently developed diabetes or died from CVD. For type 2 diabetes, age-related increase in CRP levels was less steep in the cases group than in controls, whereas for fatal CVD these trajectories were parallel

• Item Type: Articles
• Keywords: AGE ASSOCIATION body mass index BODY-MASS-INDEX C-REACTIVE PROTEIN cardiovascular disease CARDIOVASCULAR EVENTS CARDIOVASCULAR-DISEASE CARE Cohort CORONARY-HEART-DISEASE DEATH diabetes DIAGNOSIS DISEASE ENGLAND EVENTS FOLLOW-UP GLUCOSE GLUCOSE-TOLERANCE HEART INCREASE INDEX INFLAMMATORY MARKERS LEVEL MASS MELLITUS MENDELIAN RANDOMIZATION METABOLIC SYNDROME Metabolism MODEL MORTALITY MULTILEVEL PREDICTION Prospective PROSPECTIVE COHORT Prospective study PROTEIN RISK sex Type 2 diabetes TYPE-2
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lowe, Professor Gordon
• Authors: Tabak, A. G., Kivimaki, M., Brunner, E. J., Lowe, G.D., Jokela, M., Akbaraly, T. N., Singh-Manoux, A., Ferrie, J. E., and Witte, D. R.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: European Journal of Endocrinology
• ISSN: 0804-4643