The relation of markers of inflammation to the development of glucose disorders in the elderly - The cardiovascular health study
The relation of markers of inflammation to the development of glucose disorders in the elderly - The cardiovascular health study
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DOI：
10.2337/diabetes.50.10.2384
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发表时间：
2001-10-01
期刊：
影响因子：
7.7
通讯作者：
Tracy, RP
中科院分区：
文献类型：
--
作者：
Barzilay, JI;Abraham, L;Tracy, RP
一些研究表明，炎症在成人某些葡萄糖紊乱的发病机制中起作用。我们在基线空腹血糖（FG）值正常的老年人的纵向队列研究中验证了这一假设。我们比较了随访时发生葡萄糖紊乱的参与者与随访时FG保持正常的参与者的六种炎症标志物的基线水平。参与者是心血管健康研究的成员，这是一项关于65岁以上成人心血管疾病危险因素的前瞻性研究。所有5,888名参与者都进行了基线检测，包括FG和炎症标志物：白色血细胞和血小板计数以及白蛋白、纤维蛋白原、C反应蛋白（CRP）和因子VIII c水平。在3-4年的随访中，4，481（84.5%）例存活患者重新检测了FG水平。发生糖尿病的参与者（n = 45）基线时CRP的中位数水平高于血糖正常的参与者。在多变量分析中，CRP水平升高的患者（第75百分位数[2.86 mg/l] vs.第25百分位数[0.82 mg/l]）在随访时患糖尿病的可能性高2.03倍（95%置信区间，1.44-2.86）。调整混杂因素和其他炎症标志物并没有明显改变这一发现。糖尿病的发展与其他炎症标志物之间没有关系。通过CRP水平测量的炎症与老年人糖尿病的发展相关。了解炎症在该年龄组葡萄糖紊乱发病机制中的作用可能会导致更好的分类和治疗葡萄糖紊乱。
Several studies suggest that inflammation plays a role in the pathogenesis of some glucose disorders in adults. We tested this hypothesis in a longitudinal cohort study of older individuals who had normal fasting glucose (FG) values at baseline. We compared the baseline levels of six inflammatory markers in participants who had developed glucose disorders at follow-up with those of participants whose FG remained normal at follow-up. Participants were members of the Cardiovascular Health Study, a prospective study of risk factors for cardiovascular disease in adults greater than or equal to 65 years. All 5,888 participants had baseline testing, including FG and markers of inflammation: white blood cell and platelet counts and albumin, fibrinogen, C-reactive protein (CRP), and factor VIIIc levels. At 3-4 years of follow-up, 4,481 (84.5%) of those who were alive had FG levels retested. Participants who developed diabetes (n = 45) had higher median levels of CRP at baseline than those who remained normoglycemic. On multivariate analysis, those with elevated CRP levels (75th percentile [2.86 mg/l] vs. 25th percentile [0.82 mg/l]) were 2.03 times (95% confidence intervals, 1.44-2.86) more likely to have diabetes on follow-up. Adjustment for confounders and other inflammatory markers did not appreciably change this finding. There was no relationship between the development of diabetes and other markers of inflammation. Inflammation, as measured by CRP levels, is associated with the development of diabetes in the elderly. Understanding the role of inflammation in the pathogenesis of glucose disorders in this age-group may lead to better classification and treatment of glucose disorders among them.