Postload hyperglycemia is associated with increased subclinical inflammation in patients with prediabetes

Scand J Clin Lab Invest. 2013 Aug;73(5):422-7. doi: 10.3109/00365513.2013.798870. Epub 2013 Jun 14.

Abstract

Background/aims: In this present study, we aimed: (i) To clarify if prediabetes is associated with subclinical inflammation independent of underlying obesity, and (ii) to evaluate the effect of postload glucose concentration on subclinical inflammation markers in a group of patients with elevated fasting glucose.

Material and methods: In a cohort of 165 patients with newly detected fasting hyperglycemia, according to 75 g oral glucose tolerance test (OGTT), subjects were classified either as newly diagnosed type 2 diabetes (diabetes group, n = 40), impaired fasting glucose (IFG) plus impaired glucose tolerance (IGT) (IFG/IGT group, n = 42) or IFG only (IFG group, n = 83). A control group (n = 47) consisted of age- and body mass index (BMI)-matched healthy subjects with a normal OGTT. Circulating concentrations of lipids, insulin, interleukin-6 (IL-6), interleukin-8 (IL-8) and high sensitive C-reactive protein (hsCRP) were measured. HOMA index was calculated.

Results: Subclinical inflammation markers were elevated in patients with diabetes and IFG/IGT compared to healthy controls and also IFG patients (diabetes vs. control: p < 0.05 for hsCRP, IL-8, and IL-6; IFG/IGT vs. control: p < 0.05 for hsCRP, and IL-6; diabetes vs. IFG: p < 0.05 for hsCRP, and IL-6; IFG/IGT vs. IFG: p < 0.05 for hsCRP, and IL-6). In multiple regression analysis, postload glucose concentration was independently associated with circulating hsCRP and IL-6 concentrations when the data was controlled for age, gender, BMI and lipid concentrations (p < 0.05 for hsCRP, and IL-6).

Conclusion: Our results suggest that patients with prediabetes, independent of underlying obesity, have increased concentrations of subclinical inflammation which is mostly driven by postload glucose concentrations.

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Blood Glucose
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / immunology
  • Female
  • Glucose Intolerance / blood*
  • Glucose Intolerance / immunology
  • Glucose Tolerance Test
  • Humans
  • Inflammation / blood
  • Inflammation Mediators / blood*
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / immunology
  • Prediabetic State / blood*
  • Prediabetic State / immunology

Substances

  • Blood Glucose
  • IL6 protein, human
  • Inflammation Mediators
  • Interleukin-6
  • Interleukin-8
  • C-Reactive Protein