Issue 109 Item 12 Diabetes Risk in Middle-Aged Men Predicted with C-Reactive Pro

Elevated C-reactive protein (CRP) levels are associated with an increased risk of developing type 2 diabetes in middle-aged men independently of established risk factors, >British investigators report. This finding supports the theory that low-grade inflammation contributes to the pathogenesis of type 2 diabetes.

Dr. Dilys J. Freeman, of the University of Glasgow and members of the West of Scotland Coronary Prevention Study Group obtained plasma samples at baseline from 5245 men, mean age 55.6 years. According to their report in the May issue of Diabetes, 127 subjects developed diabetes during 5 years of follow-up.

The mean natural logarithm of sensitive CRP was 1.05 among those who developed diabetes versus 0.53 for the remainder of subjects, indicating its strong predictive value (p < 0.0001). Individuals with CRP greater than 4.18 mg/L had more than six times the risk of diabetes compared with those with CRP levels 0.66 mg/L or lower.

After adjustment for baseline body mass index, natural log triglyceride, blood glucose, systolic blood pressure, total and HDL cholesterol, and natural log white cell count, log CRP level remained a significant predictor of diabetes (p = 0.0075).

According to the authors, these findings complement a similar observation of elevated risk for diabetes in women with higher CRP values. The association is strengthened by the ability of weight loss, thiazolidinediones, statins, and ACE inhibitors to decrease insulin resistance while exerting significant anti-inflammatory effects. Dr. Freeman’s team suggests that inflammatory cytokines may produce insulin resistance through their effect on insulin receptors or by stimulating adipocyte lipolysis.

Diabetes 2002;51:1596-1600.