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Diabetes Care 29:1902-1908, 2006
DOI: 10.2337/dc05-2327
© 2006 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Article

Diabetes, Hyperglycemia, and Inflammation in Older Individuals

The Health, Aging and Body Composition study

Nathalie de Rekeneire, MD, MS1, Rita Peila, PHD1, Jingzhong Ding, PHD2, Lisa H. Colbert, PHD3, Marjolein Visser, PHD4, Ronald I. Shorr, MD, MS5, Stephen B. Kritchevsky, PHD2, Lewis H. Kuller, MD, DRPH6, Elsa S. Strotmeyer, PHD6, Ann V. Schwartz, PHD7, Bruno Vellas, MD, PHD8 and Tamara B. Harris, MD, MS1

1 Laboratory of Epidemiology, National Institute on Aging, Bethesda, Maryland
2 Sticht Center on Aging, Wake Forest, Winston-Salem, North Carolina
3 Department of Kinesiology, University of Wisconsin–Madison, Madison, Wisconsin
4 Department of Nutrition and Health, Vrije University Medical Center, Amsterdam, the Netherlands
5 Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee
6 Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
7 Department of Epidemiology and Biostatistics, University of California, San Francisco, California
8 Department of Internal Medicine and Clinical Gerontology, University of Toulouse, Toulouse, France

Address correspondence and reprint requests to Nathalie de Rekeneire, MD, Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Gateway Building, Suite 3C-309, 7201 Wisconsin Ave., Bethesda, MD 20892-9205. E-mail: rekenein{at}nia.nih.gov

OBJECTIVE—The objective of this study was to assess the association of inflammation with hyperglycemia (impaired fasting glucose [IFG]/impaired glucose tolerance [IGT]) and diabetes in older individuals.

RESEARCH DESIGN AND METHODS—Baseline data from the Health, Aging and Body Composition study included 3,075 well-functioning black and white participants, aged 70–79 years.

RESULTS—Of the participants, 24% had diabetes and 29% had IFG/IGT at baseline. C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-{alpha} (TNF-{alpha}) levels (P < 0.001) were significantly higher among diabetic participants and those with IFG/IGT. Odds of elevated IL-6 and TNF-{alpha} (>75th percentile) were, respectively, 1.95 (95% CI 1.56–2.44) and 1.88 (1.51–2.35) for diabetic participants and 1.51 (1.21–1.87) and 1.14 (0.92–1.42) for those with IFG/IGT after adjustment for age, sex, race, smoking, alcohol intake, education, and study site. Odds ratios for elevated CRP were 2.90 (2.13–3.95) and 1.45 (1.03–2.04) for diabetic women and men and 1.33 (1.07–1.69) for those with IFG/IGT regardless of sex. After adjustment for obesity, fat distribution, and inflammation-related conditions, IL-6 remained significantly related to both diabetes and IFG/IGT. CRP in women and TNF-{alpha} in both sexes were significantly related to diabetes, respectively, whereas risk estimates for IFG/IGT were decreased by adjustment for adiposity. Among diabetic participants, higher levels of HbA1c were associated with higher levels of all three markers of inflammation, but only CRP remained significant after full adjustment.

CONCLUSIONS—Our findings show that dysglycemia is associated with inflammation, and this relationship, although consistent in diabetic individuals, also extends to those with IFG/IGT.

Abbreviations: CRP, C-reactive protein • Health ABC, Health, Aging and Body Composition • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • IL-6, interleukin-6 • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test • TNF-{alpha}, tumor necrosis factor-{alpha}


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