scholarly journals Higher baseline inflammatory marker levels predict greater cognitive decline in older people with type 2 diabetes: year 10 follow-up of the Edinburgh Type 2 Diabetes Study

Diabetologia ◽  
2021 ◽  
Author(s):  
Anniek J. Sluiman ◽  
Stela McLachlan ◽  
Rachel B. Forster ◽  
Mark W. J. Strachan ◽  
Ian J. Deary ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older People ◽  
Cognitive Ability ◽  
Cognitive Change ◽  
General Cognitive Ability ◽  
C Reactive Protein ◽  
Cognitive Domains ◽  
Reactive Protein ◽  
Related Risk

Abstract Aims/hypothesis We aimed to determine the longitudinal association of circulating markers of systemic inflammation with subsequent long-term cognitive change in older people with type 2 diabetes. Methods The Edinburgh Type 2 Diabetes Study is a prospective cohort study of 1066 adults aged 60 to 75 years with type 2 diabetes. Baseline data included C-reactive protein, IL-6, TNF-α fibrinogen and neuropsychological testing on major cognitive domains. Cognitive testing was repeated after 10 years in 581 participants. A general cognitive ability score was derived from the battery of seven individual cognitive tests using principal component analysis. Linear regression was used to determine longitudinal associations between baseline inflammatory markers and cognitive outcomes at follow-up, with baseline cognitive test results included as covariables to model cognitive change over time. Results Following adjustment for age, sex and baseline general cognitive ability, higher baseline fibrinogen and IL-6 were associated with greater decline in general cognitive ability (standardised βs = −0.059, p=0.032 and −0.064, p=0.018, respectively). These associations lost statistical significance after adjustment for baseline vascular and diabetes-related covariables. When assessing associations with individual cognitive tests, higher IL-6 was associated with greater decline in tests of executive function and abstract reasoning (standardised βs = 0.095, p=0.006 and −0.127, p=0.001, respectively). Similarly, raised fibrinogen and C-reactive protein levels were associated with greater decline in processing speed (standardised βs = −0.115, p=0.001 and −0.111, p=0.001, respectively). These associations remained statistically significant after adjustment for the diabetes- and vascular-related risk factors. Conclusions/interpretation Higher baseline levels of inflammatory markers, including plasma IL-6, fibrinogen and C-reactive protein, were associated with subsequent cognitive decline in older people with type 2 diabetes. At least some of this association appeared to be specific to certain cognitive domains and to be independent of vascular and diabetes-related risk factors. Graphical abstract

scholarly journals Association between fasting insulin and C-reactive protein among adults without diabetes using a two-part model: NHANES 2005–2010

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Amanda L. Missel ◽  
Laura R. Saslow ◽  
Dina H. Griauzde ◽  
Donna Marvicsin ◽  
Ananda Sen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Low Grade ◽  
Fasting Insulin ◽  
C Reactive Protein ◽  
Glucose Levels ◽  
Reactive Protein ◽  
Part Model

Abstract Introduction Chronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes. Hyperglycemia is associated with chronic low-grade inflammation, and thus has become the focus of many screening and treatment recommendations. We hypothesize that insulin may also be associated with inflammation and may be an additional factor to consider in screening and treatment. Methods This study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). A two-part model was used due to the high number of values reported as 0.1 mg/L. Two models were analyzed, both with and without the addition of waist circumference to other covariates in the model. Results The final sample included 4527 adults with a mean age of 43.31 years. In the first model, higher fasting insulin was associated with increased odds of CRP > 0.1 mg/L (OR = 1.02, p < .001) and with higher CRP (β = 0.03, p < .001). In the adjusted model, including waist circumference as a covariate, higher fasting insulin was not associated with CRP > 0.1 mg/L (OR = 1.00, p = .307) but the association between higher fasting insulin and higher continuous CRP remained significant (β = 0.01, p = .012). Conclusion This study found that higher fasting insulin is associated with higher CRP. These results suggest that treatment approaches that simultaneously decrease insulin levels as well as glucose levels may provide additive anti-inflammatory effects, and therefore may improve long-term outcomes for adults with type 2 diabetes.

C-reactive protein: a marker or a player?

2007 ◽  
Vol 113 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Thomas Nyström
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Protein A ◽  
Low Grade ◽  
Phase Reaction ◽  
Clinical Markers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

It has been suggested that Type 2 diabetes may, in part, be precipitated or accelerated by an acute-phase reaction as part of the innate immune response, in which large amounts of cytokines are released from adipose tissue, creating a low-grade inflammatory milieu. There is also firm evidence that atherosclerosis is an immune-mediated inflammatory disease. Therefore it is reasonable to imply that low-grade inflammation is an important pathogenetic factor in atherosclerosis and cardiovascular events in patients with Type 2 diabetes. Over the last few years, there have been a lot of promising clinical markers proposed to link inflammation and atherosclerosis. Of these markers, hs-CRP (high-sensitivity C-reactive protein) might be a prognostic marker for further cardiovascular events, although this has been refuted recently. In this issue of Clinical Science, Castoldi and co-workers have demonstrated that, in patients with Type 2 diabetes categorized into low (<1.0 mg/l), medium (1.0–3.0 mg/l) and high (>3.0 mg/l) hs-CRP groups, serum levels of hs-CRP correlated with lipopolysaccharide-stimulated release of interleukin-1β and interleukin-6 in whole blood. This finding may indicate that low-grade inflammatory activity might influence cytokine production in these patients.

scholarly journals Prospective Relation of C-Reactive Protein With Type 2 Diabetes: Response to Han et al.

Diabetes Care ◽  
2003 ◽  
Vol 26 (5) ◽  
pp. 1656-1657 ◽  
Author(s):  
M. B. Snijder ◽  
J. M. Dekker ◽  
M. Visser ◽  
C. D.A. Stehouwer ◽  
J. S. Yudkin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
C Reactive Protein ◽  
Reactive Protein

Abstract P137: Aerobic, Resistance or Combination Exercise Training does not Reduce C-Reactive Protein Levels in Individuals with Type 2 Diabetes

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Damon L Swift ◽  
Neil M Johannsen ◽  
Conrad P Earnest ◽  
Steven N Blair ◽  
Timothy S Church
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Aerobic Exercise ◽  
Fat Mass ◽  
Fasting Glucose ◽  
Aerobic Exercise Training ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Introduction: Type 2 diabetes is associated with elevated C-reactive protein levels (CRP), which is an independent risk factor for cardiovascular disease. Aerobic exercise training especially with weight/adiposity reduction has been shown to improve CRP, however few studies have evaluated the effect of other exercise training modalities (aerobic, resistance or combination training) on CRP in individuals with type 2 diabetes. Hypothesis: We hypothesize that combination training will improve CRP to a greater extent than other modalities of exercise training, and change in CRP levels will be associated with changes in weight and adiposity. Methods: The present study is a secondary analysis of the Health Benefits of Aerobic and Resistance Training in Individuals with Type 2 Diabetes (HART-D) study. Participants (n=204) were randomized to aerobic exercise (aerobic), resistance exercise (resistance) or a combination of both (combination) for nine months. Results: Baseline CRP was correlated with fat mass, waist circumference, BMI, and inversely correlated with VO2 peak (p<0.05). CRP was not reduced in the aerobic (0.16 mg•L-1, 95% CI: -1.0, 1.3), resistance (-0.03 mg•L-1, 95% CI: -1.1, 1.0) or combination (-0.49 mg•L-1, 95% CI: -1.5 to 0.6) groups compared to control (0.35 mg•L-1, 95% CI: -1.0, 1.7). Change in CRP was associated with change in fasting glucose (r=0.20, p= 0.009), glycated hemoglobin (HbA1C) (r=0.21 p=0.005), and fat mass (r=0.19, p=0.016), but not change in fitness or weight (p > 0.05). Conclusions: In conclusion, aerobic, resistance or a combination of both did not reduce CRP levels in individuals with type 2 diabetes. However, exercise related improvements in HbA1C, fasting glucose, and fat mass were associated with reductions in CRP.

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