Abstract P329: High-Sensitivity C-Reactive Protein is Associated With Incident Type 2 Diabetes Mellitus Among African-Americans: The Jackson Heart Study
Introduction: Previous studies on the association between high-sensitivity C-reactive protein (hs-CRP) and incident type 2 diabetes mellitus (T2DM) among African-Americans have been inconclusive. We assess the association between hs-CRP and incident T2DM in the Jackson Heart Study, a large African-American cohort.
Methods: The study included 3,340 participants without T2DM at baseline (2000-2004). Incident T2DM was defined as fasting glucose ≥ 126 mg/dl, physician diagnosis, use of diabetes drugs, or HbA1c ≥ 6.5% at one of two follow-up exams. Hs-CRP was measured by CRP-Latex assay. Cox regression was used to estimate hazard ratios (HR) for incident T2DM, adjusting for age, sex, education, alcohol, BMI, waist circumference, blood pressure, physical activity, HOMAIR, HDL, and triglycerides.
Results: Participants were aged 53.3 ± 12.5 years (63% women). After a median follow-up of 7.5 years, 17.4% (581 of 3,340) developed T2DM (23.1/1000 person-years, 95%CI: 21.3 - 25.1). Hs-CRP levels were 3.5 and 2.3 mg/l in those who developed T2DM and those who did not, respectively (p<0.0001). After adjustment for covariates, the HR for incident T2DM (third tertile versus first of hs-CRP) was 1.64 (95% CI: 1.28 - 2.10). Further adjustment for BMI and waist circumference in separate models attenuated this association (HR 1.32 [1.02-1.72] and 1.34 [1.04-1.74], respectively, P trend < 0.05). When further adjusted for HOMAIR, the association was no longer statistically significant. In adjusted obesity-stratified analysis, the hs-CRP-T2DM association appeared stronger in non-obese (BMI < 30 kgm-2) compared to obese (BMI ≥ 30 kgm-2) participants (P interaction = 0.01) (Figure 1). A similar pattern was observed in analysis stratified by waist circumference.
Conclusions: In this study, the association between hs-CRP and incident T2DM is largely explained by obesity and insulin resistance measures. Our findings also suggest that hs-CRP may have an important role in T2DM development among non-obese African-Americans.
Author Disclosures: V.S. Effoe: None. A. Correa: None. H. Chen: None. M.E. Lacy: None. A.G. Bertoni: None.
- © 2015 by American Heart Association, Inc.