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Risk of Type 2 Diabetes Attributable to C-Reactive Protein and Other Risk Factors

¹ Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
² Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands

Address correspondence and reprint requests to Dr. J.C.M. Witteman, PhD, Department of Epidemiology and Biostatistics, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, Netherlands. E-mail: j.witteman{at}erasmusmc.nl

OBJECTIVE— To calculate the population-attributable risk (PAR) of C-reactive protein (CRP) and other risk factors for type 2 diabetes.

RESEARCH DESIGN AND METHODS— The Rotterdam Study is a population-based, prospective follow-up study among 7,983 participants aged 55 years. Risk factors including serum CRP were determined at baseline. Participants with diabetes at baseline were excluded, and the cohort was followed for a mean of 10.8 years. The hazard ratio (HR) and PAR for diabetes were computed for all studied risk factors.

RESULTS— Serum CRP >1 mg/l (HR 1.67, PAR 0.33), BMI >25 kg/m² (HR 2.51, PAR 0.51), waist circumference >102 for men and >88 cm for women (HR 1.36, PAR 0.14), current smoking (HR 1.16, PAR 0.03), age >65 years (HR 1.35, PAR 0.15), and family history of diabetes (HR 1.87, PAR 0.16) were related to diabetes and contributed to the risk of the disease. Serum CRP was a greater contributor to the risk of diabetes in women than in men (PAR values of 0.37 vs. 0.28, respectively). Age and current smoking PARs were not statistically significantly contributing to the risk of diabetes in women. Combined PAR was 0.80 (95% CI 0.74–0.85) for all six studied risk factors and 0.71 (0.64–0.78) for modifiable risk factors (serum CRP, BMI, waist circumference, and current smoking).

CONCLUSIONS— High CRP is one of the major contributors to the risk of type 2 diabetes. The contribution of modifiable risk factors to the risk of diabetes is considerable.

Abbreviations: CRP, C-reactive protein • PAR, population-attributable risk

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