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Heras Gala, Tonia de las; Herder, Christian; Rutters, Femke; Carstensen-Kirberg, Maren; Huth, Cornelia; Stehouwer, Coen D. A.; Nijpels, Giel; Schalkwijk, Casper; Flyvbjerg, Allan; Franks, Paul W.; Dekker, Jacqueline; Meisinger, Christa; König, Wolfgang; Roden, Michael; Rathmann, Wolfgang; Peters, Annette; Thorand, Barbara (2018): Association of changes in inflammation with variation in glycaemia, insulin resistance and secretion based on the KORA study. In: Diabetes-Metabolism Research and Reviews, Vol. 34, No. 8, e3063
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Abstract

Aims Subclinical systemic inflammation may contribute to the development of type 2 diabetes, but its association with early progression of glycaemic deterioration in persons without diabetes has not been fully investigated. Our primary aim was to assess longitudinal associations of changes in pro-inflammatory (leukocytes, high-sensitivity C-reactive protein (hsCRP)) and anti-inflammatory (adiponectin) markers with changes in markers that assessed glycaemia, insulin resistance, and secretion (HbA(1c), HOMA-IR, and HOMA-beta). Furthermore, we aimed to directly compare longitudinal with cross-sectional associations. Materials and methods Results This study includes 819 initially nondiabetic individuals with repeated measurements from the Cooperative Health Research in the Region of Augsburg (KORA) S4/F4 cohort study (median follow-up: 7.1 years). Longitudinal and cross-sectional associations were simultaneously examined using linear mixed growth models. Changes in markers of inflammation were used as independent and changes in markers of glycaemia/insulin resistance/insulin secretion as dependent variables. Models were adjusted for age, sex, major lifestyle and metabolic risk factors for diabetes using time-varying variables in the final model. Changes of leukocyte count were positively associated with changes in HbA(1c) and HOMA-beta while changes in adiponectin were inversely associated with changes in HbA(1c). All examined cross-sectional associations were statistically significant;they were generally stronger and mostly directionally consistent to the longitudinal association estimates. Conclusion: s Adverse changes in low-grade systemic inflammation go along with glycaemic deterioration and increased insulin secretion independently of changes in other risk factors, suggesting that low-grade inflammation may contribute to the development of hyperglycaemia and a compensatory increase in insulin secretion.