Abstract
Background: We performed a cohort study to evaluate the association between the CRP trajectory and incident diabetes in Chinese adults. Methods: Included were 6,439 adults (4,111 men and 2,249 women; aged 46.6±11.9 years). The concentration of high sensitivity CRP (hs-CRP) was measured in 2013 (baseline), 2014, and 2015. The hs-CRP trajectory was identified based the above three measurements by latent mixture modeling. Incident diabetes cases were diagnosed by fasting blood glucose (³126mg/dl) or Hb A1c (³6.5%) during subsequent three years (2016-2018). Results: Hs-CRP concentration during 2013 -2015 was classified into 3 levels: low (<1.0 mg/L), moderate (1.0–3.0 mg/L), and high (³3.0 mg/L) based on a statement by American Heart Association. We named four hs-CRP trajectories as following: “low-stable” (low in 2013 and maintained at low concentration in 2014 and 2015), “moderate-fluctuated” (moderate in 2013, then increased to high concentration in 2014, and decreased to low concentration in 2015), “high-decreased” (high in 2013 but decreased to moderate concentration in 2014 and 2015), and “moderate-increased (moderate in 2013 and increased to high concentration in 2014 and 2015)”. We identified 235 incident diabetes during subsequent three years. The adjusted HR for incident diabetes was 1.71 (95% CI: 1.02, 2.87) comparing the moderate-increased and the low-stable group, after adjusting for potential confounders. In the secondary analyses, two single-measured hs-CRP concentration (in 2013 or in 2015) and the average of hs-CRP were associated with high risk of diabetes (P-trend<0.01 for all). Conclusions: The hs-CRP trajectory pattern was associated with altered incident diabetes in Chinese adults.
The trajectory of high sensitivity C-reactive protein is associated with incident diabetes in Chinese adults