High-sensitivity C-reactive protein and risk of type 2 diabetes: A nationwide cohort study and updated meta-analysis

Xue Yang; Siyuan Tao; Jieru Peng; Jian Zhao; Sheyu Li; Nianwei Wu; Ying Wen; Qingping Xue; Chun-Xia Yang; Xiong-Fei Pan

doi:10.1002/dmrr.3446

High-sensitivity C-reactive protein and risk of type 2 diabetes: A nationwide cohort study and updated meta-analysis

Diabetes Metab Res Rev. 2021 Nov;37(8):e3446. doi: 10.1002/dmrr.3446. Epub 2021 Mar 29.

Authors

Xue Yang¹, Siyuan Tao², Jieru Peng³, Jian Zhao^{4

5}, Sheyu Li⁶, Nianwei Wu⁷, Ying Wen⁸, Qingping Xue¹, Chun-Xia Yang¹, Xiong-Fei Pan^{9

10

11}

Affiliations

¹ Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
² Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
³ Department of Medical Records Statistics, Chengdu Women and Children' s Central Hospital, University of Electronic Science and Technology, Chengdu, Sichuan, China.
⁴ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
⁵ MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
⁶ Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
⁷ Department of Health and Social Behavior, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
⁸ Department of Communicable Diseases Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China.
⁹ Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁰ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Environmental Protection Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
¹¹ The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 33686799
DOI: 10.1002/dmrr.3446

Abstract

Objective: To prospectively examine the association of high sensitivity C-reactive protein (hs-CRP) with incident type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese, and validate the association in an updated meta-analysis of prospective studies.

Methods: We used data from the China Health and Retirement Longitudinal Study, started in 2011-2012 with follow ups in 2013-2014 and 2015-2016. Multivariable Cox proportional hazard regressions were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between hs-CRP level and incident T2DM. An updated meta-analysis was conducted to combine our estimates with those in previous prospective studies.

Results: Included in the analyses were 7985 participants (mean age: 59.38 years; men: 46.73%). Higher hs-CRP was associated with increased risk of T2DM (multivariable-adjusted HR, 1.30; 95% CI: 1.03, 1.64 for comparing extreme quartiles). The association was stronger in participants with body mass index (BMI) of 24.0 kg/m² or higher than those with a BMI lower than 24.0 kg/m² (p for interaction = 0.038). In a meta-analysis of 28 cohorts, 2 case-cohort, and 6 nested case-control studies among 125,356 participants with 10,759 cases, the pooled relative risk for T2DM was 1.77 (95% CI: 1.60, 1.96) for the highest versus lowest level of hs-CRP.

Conclusions: Hs-CRP was associated with higher risk of T2DM in middle-aged and elderly Chinese, and this association was confirmed by an updated meta-analysis of prospective studies. Our findings highlight the role of elevated hs-CRP in the development of T2DM.

Keywords: C-reactive protein; association; cohort study; meta-analysis; type 2 diabetes mellitus.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

C-Reactive Protein* / metabolism
Cohort Studies
Diabetes Mellitus, Type 2* / epidemiology
Diabetes Mellitus, Type 2* / etiology
Diabetes Mellitus, Type 2* / metabolism
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Risk Factors

Substances

C-Reactive Protein