Abstract 19539: Associations of Soluble CD14, Interleukin-6, C-Reactive Protein and Leukocyte Count With Insulin Resistance and Incident Diabetes in Older Adults
Background: The roles of fat mass expansion and inflammation in insulin resistance and diabetes are well recognized. Experiments show that sCD14, an acute phase protein released by the liver or secreted by macrophages, modulates inflammatory activity and insulin resistance. Whether sCD14 is a risk factor for clinical dysglycemia, and how this association compares to other markers of inflammation, has not been studied.
Methods: We investigated associations of sCD14, IL-6, CRP and total WBC with insulin resistance (QUICKI, HOMA2-IR) and incident diabetes in the Cardiovascular Health Study, a population-based cohort of adults ≥65 years. Since the mostly white original cohort (1989) and black supplemental cohort (1992) had different extents of f/u glucose ascertainment, analyses were race-stratified. Linear and Cox regression models adjusted for age, sex, BMI, SBP, HTN medication, smoking, alcohol, physical activity, eGFR, estrogen, CVD and CHF.
Results: There were 5380 subjects not on baseline anti-glycemic therapy (age 73±6, 58% women, 14% black). After adjustment, sCD14 showed associations with both insulin resistance measures in whites but not blacks (Table). IL-6, CRP and WBC were associated with one or both measures in both race groups, but were strongest for WBC. These associations persisted after joint inclusion for all markers except sCD14 (not shown). After f/u through 2011, 376 (whites) and 84 (blacks) diabetes cases occurred. sCD14 was not associated with diabetes in whites or blacks (Table). IL-6, CRP and WBC were associated with diabetes in whites but not blacks, again strongest for WBC. After joint inclusion, these persisted for CRP and WBC but not IL-6.
Conclusions: In older adults, sCD14 was associated with insulin resistance, but not incident diabetes, in whites, whereas IL-6, CRP and WBC were associated with both outcomes in whites, but only insulin resistance in the smaller black subgroup. WBC emerged as the strongest determinant of dysglycemic risk.
Author Disclosures: S.G. Shitole: None. M.L. Biggs: None. A.P. Reiner: None. K.J. Mukamal: None. L. Djoussé: None. J.H. Ix: None. R.P. Tracy: None. D. Siscovick: None. J.R. Kizer: Ownership Interest; Significant; Gilead Sciences, Inc; Pfizer, Inc.
- © 2016 by American Heart Association, Inc.