Inflammatory Marker Predicts Type 2 Diabetes Risk

Researchers have identified chronic inflammation as a new risk factor for developing type 2 diabetes. In particular plasminogen activator inhibitor-1 (PAI-1), as an independent predictor of type 2 diabetes.

Writing in the April issue of Diabetes, Dr. Steven M. Haffner, from The University of Texas Health Science Center at San Antonio, and colleagues collected data on 1047 nondiabetics who participated in the Insulin Resistance Atherosclerosis Study. In this population, the researchers measured baseline C-reactive protein, fibrinogen, and PAI-1 concentrations.

During 5 years of follow-up, 144 subjects developed type 2 diabetes. Compared with nondiabetics, subjects who developed type 2 diabetes had higher baseline fibrinogen levels (mean 275.1 mg/dL versus 287.8 mg/dL.) Concentrations of C-reactive protein were also higher in diabetics (median 2.40 mg/L) compared with nondiabetics, the researchers found.

Baseline PAI-1 concentrations were also higher in patients who developed type 2 diabetes compared with nondiabetics (24 ng/mL versus 16 ng/mL), Dr. Haffner’s group adds.

When the investigators adjusted the data to take into account body fat and insulin sensitivity the association between diabetes and fibrinogen and C-reactive protein was significantly attenuated, while the association with PAI-1 did not diminish.

Regression analysis that adjusted for age, sex, ethnicity, clinical center, smoking, body mass index, insulin sensitivity, physical activity, and family history of diabetes, showed that PAI-1 remained a significant factor in the incidence of type 2 diabetes (odds ratio 1.61, p = 0.0017).

Dr. Haffner and colleagues conclude that "high PAI-1 levels in subjects with normal glucose tolerance may help to identify a high-risk population with the potential to prevent both atherosclerotic disease and type 2 diabetes, two major causes of premature morbidity and morality, by targeting its common antecedent." Diabetes 2002;51:1131-1137.