C-reactive protein is more strongly related to post-glucose load glucose than to fasting glucose in non-diabetic subjects; the Insulin Resistance Atherosclerosis Study

  1. A. Festa1,
  2. R. D’Agostino Jr1,2,
  3. R. P. Tracy1,3,
  4. S. M. Haffner1,*

Article first published online: 6 NOV 2002

DOI: 10.1046/j.1464-5491.2002.00824.x

Issue

Diabetic Medicine

Diabetic Medicine

Volume 19, Issue 11, pages 939–943, November 2002

Additional Information

How to Cite

Festa, A., D’Agostino, R., Tracy, R. P. and Haffner, S. M. (2002), C-reactive protein is more strongly related to post-glucose load glucose than to fasting glucose in non-diabetic subjects; the Insulin Resistance Atherosclerosis Study. Diabetic Medicine, 19: 939–943. doi: 10.1046/j.1464-5491.2002.00824.x

Author Information

  1. 1

    Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, TX,

  2. 2

    Department of Public Health Sciences, Bowman Gray School of Medicine, Winston Salem, NC, and

  3. 3

    Laboratory for Clinical Biochemistry Research, Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA

* Steven M. Haffner MD, The University of Texas Health Science Center at San Antonio, Mail Code 7873, 7703 Floyd Curl Drive, San Antonio, TX 78228-3900, USA. E-mail: haffner@uthscsa.edu

Publication History

  1. Issue published online: 6 NOV 2002
  2. Article first published online: 6 NOV 2002
  3. Accepted 31 May 2002

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Keywords:

  • inflammation;
  • C-reactive protein;
  • insulin resistance;
  • post-challenge plasma glucose;
  • atherosclerosis

Abstract

Aims It has been suggested that cardiovascular disease may be more strongly related to post-challenge glycaemia than to fasting glucose concentrations. We hypothesized that subclinical inflammation, as indicated by elevated serum levels of C-reactive protein (CRP), may partially explain the association of cardiovascular disease with post-challenge glycaemia.

Methods We studied the relationship of CRP (measured with a highly sensitive immunoassay) with fasting glucose and 2-h glucose concentrations during an oral glucose tolerance test in non-diabetic subjects from the Insulin Resistance Atherosclerosis Study.

Results Spearman correlation analyses and multiple linear regression analyses showed a significant association of both fasting glucose and 2-h glucose concentrations with CRP levels, after adjusting for demographic covariates (age, sex, ethnicity, clinical centre; Spearman correlation coefficients: r = 0.18 for fasting glucose, r = 0.27 for 2-h glucose, both P < 0.0001). However, after additional adjustment for body mass index and waist–hip ratio only 2-h glucose (and not fasting glucose) was significantly related to CRP (r = 0.03 for fasting glucose, P = NS; r = 0.14 for 2-h glucose, P < 0.0001). Adding insulin sensitivity to the multivariate models further weakened the relationship of CRP to 2-h glucose (r = 0.07, P < 0.05). CRP mean values increased by 2-h glucose category (normal vs. impaired glucose tolerance vs. isolated post-challenge hyperglycaemia).

Conclusions Chronic, subclinical inflammation, as indicated by elevated circulating CRP levels, is more strongly associated with post-challenge glycaemia than with fasting glucose levels in non-diabetic subjects. This association is partially independent of body fat and insulin resistance.

Diabet. Med. 19, 939–943 (2002)

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