Background
Methods
Study population
Measurements
Diagnosis of T2DM and pre-T2DM
Statistical analysis
Results
Characteristics of participants
White | Black | p for race differencea | ||||
---|---|---|---|---|---|---|
Male (n = 138) | Female (n = 222) | Male (n = 38) | Female (n = 111) | Male | Female | |
Baseline survey | ||||||
Age (years) | 36.4 (4.5) | 36.2 (4.2) | 36.6 (4.2) | 35.0 (4.5) | 0.975 | 0.041 |
BMI (kg/m2) | 28.1 (4.9) | 27.2 (6.2) | 29.4 (6.7) | 31.3 (7.8) | 0.286 | < 0.001 |
Smoking, n (%) | 35 (25.4) | 41 (18.5) | 15 (39.5) | 33 (29.7) | 0.088 | 0.020 |
Alcohol drinking, n (%) | 54 (39.1) | 98 (44.1) | 8 (21.1) | 42 (37.8) | 0.039 | 0.272 |
Glucose (mg/dL) | 83.5 (9.4)** | 79.6 (8.1) | 83.2 (8.9) | 81.2 (9.3) | 0.861 | 0.121 |
Insulin (μU/mL)b | 10.0 (7.0–14.0)* | 8.0 (6.0–13.0) | 9.0 (5.0–17.0) | 11.0 (7.0–17.0) | 0.782 | 0.001 |
HOMA-IRb | 2.04 (1.45–2.82)* | 1.65 (1.11–2.60) | 1.89 (1.06–3.66) | 2.27 (1.43–3.46) | 0.786 | 0.001 |
hsCRP (mg/L)b | 0.93 (0.37–1.93)** | 1.65 (0.71–4.15) | 1.78 (0.60–3.09) | 2.07 (0.58–4.80) | 0.131 | 0.830 |
Pre-diabetes, n (%) | 5 (3.6) | 3 (1.4) | 2 (5.3) | 2 (1.8) | 0.155 | 0.255 |
Follow-up survey | ||||||
Age (years) | 43.2 (4.7) | 43.0 (4.5) | 43.6 (4.5) | 41.9 (4.7) | 0.674 | 0.043 |
Follow-up period (years) | 6.8 (0.9) | 6.8 (0.9) | 7.0 (0.8) | 6.9 (0.9) | 0.222 | 0.123 |
BMI (kg/m2) | 29.6 (5.6) | 28.6 (6.7) | 31.8 (8.2) | 33.0 (8.2) | 0.131 | < 0.001 |
Smoking, n (%) | 32 (23.2) | 50 (22.5) | 15 (39.5) | 33 (29.7) | 0.045 | 0.152 |
Alcohol drinking, n (%) | 52 (37.7) | 91 (41.0) | 7 (18.4) | 38 (34.2) | 0.026 | 0.233 |
Glucose (mg/dL) | 90.6 (10.7)** | 86.7 (8.8) | 92.5 (12.2)** | 88.8 (8.6) | 0.345 | 0.036 |
Insulin (μU/mL)b | 10.1 (6.3–16.2)* | 8.2 (5.1–13.0) | 13.6 (6.7–24.0) | 12.8 (6.96–18.9) | 0.052 | < 0.001 |
HOMA-IRb | 2.26 (1.35–3.63)* | 1.74 (1.04–3.00) | 3.33 (1.20–5.78) | 2.82 (1.43–4.56) | 0.065 | < 0.001 |
hsCRP (mg/L)b | 0.93 (0.41–1.97)** | 1.35 (0.52–3.14) | 1.09 (0.56–2.94) | 2.07 (0.58–4.80) | 0.186 | 0.062 |
Pre-diabetes, n (%) | 22 (15.9)* | 19 (8.6) | 11 (29.0)** | 10 (9.0) | 0.069 | 0.891 |
Outcome survey | ||||||
Age (years) | 49.6 (4.5) | 49.5 (4.2) | 50.1 (4.2)* | 48.0 (4.7) | 0.547 | 0.003 |
Follow-up period (year)c | 6.0 (1.1) | 6.1 (1.1) | 6.2 (1.1) | 5.9 (1.1) | 0.386 | 0.067 |
BMI (kg/m2) | 30.3 (5.4) | 29.5 (6.7) | 32.3 (8.6) | 34.9 (8.5) | 0.085 | < 0.001 |
Smoking, n (%) | 33 (23.9) | 45 (20.3) | 20 (52.6)** | 27 (24.3) | < 0.001 | 0.397 |
Alcohol drinking, n (%) | 71 (51.5) | 88 (55.4) | 18 (47.4)** | 18 (16.2) | 0.656 | < 0.001 |
Hyperglycemia, n (%) | 76 (55.1)** | 78 (35.1) | 27 (71.1)* | 50 (45.1) | 0.077 | 0.080 |
Pre-diabetes, n (%) | 61 (44.2)** | 51 (22.9) | 17 (44.8)* | 34 (30.7) | 0.288 | 0.091 |
T2DM, n (%) | 15 (10.9) | 27 (12.2) | 10 (26.3) | 16 (14.4) | 0.016 | 0.563 |
Correlations between hsCRP and HOMA-IR at baseline and follow-up
Group | Variable | Baseline hsCRP | Baseline HOMA-IR | Follow-up hsCRP |
---|---|---|---|---|
Totala | Baseline HOMA-IR | 0.102 | ||
Follow-up hsCRP | 0.473 | 0.053 | ||
Follow-up HOMA-IR | 0.147 | 0.418 | 0.187 | |
White/blackb | Baseline HOMA-IR | 0.108/0.090 | ||
Follow-up hsCRP | 0.494/0.416 | 0.082/− 0.014 | ||
Follow-up HOMA-IR | 0.154/0.152 | 0.437/0.369 | 0.248/0.043* | |
Male/femalec | Baseline HOMA-IR | 0.036/0.139 | ||
Follow-up hsCRP | 0.444/0.495 | 0.029/0.068 | ||
Follow-up HOMA-IR | 0.060/0.190 | 0.460/0.396 | 0.161/0.201 | |
Normo/hyperd | Baseline HOMA-IR | 0.146/0.043 | ||
Follow-up hsCRP | 0.483/0.455 | 0.034/0.064 | ||
Follow-up HOMA-IR | 0.129/0.175 | 0.340/0.437 | 0.121/0.268 |
Cross-lagged path analysis of hsCRP and HOMA-IR
Cross-lagged path analyses by subgroups
Path coefficients | Goodness-of-fit | ||||||
---|---|---|---|---|---|---|---|
HOMA-IR → hsCRP | hsCRP → HOMA-IR | pa | RMR | CFI | |||
β1 | p | β2 | p | ||||
Glycemia status | |||||||
Normoglycemia (n = 278) | − 0.037 | 0.483 | 0.081 | 0.155 | 0.032 | 0.022 | 0.990 |
Hyperglycemia (n = 231) | 0.045 | 0.449 | 0.156 | 0.008 | 0.059 | 0.054 | 0.914 |
T2DM (n = 68) | 0.131 | 0.206 | 0.143 | 0.199 | 0.911 | 0.031 | 0.994 |
Pre-T2DM (n = 163) | 0.006 | 0.938 | 0.177 | 0.012 | 0.015 | 0.061 | 0.884 |
pb | 0.141 | 0.194 | |||||
pc | 0.011 | 0.380 | |||||
pd | 0.475 | 0.121 | |||||
Race | |||||||
White (n = 360) | 0.029 | 0.530 | 0.108 | 0.023 | 0.111 | 0.097 | 0.932 |
Black (n = 149) | − 0.052 | 0.490 | 0.120 | 0.117 | 0.022 | 0.148 | 1.000 |
pe | 0.148 | 0.843 | |||||
Sex | |||||||
Male (n = 176) | 0.013 | 0.848 | 0.044 | 0.518 | 0.645 | 0.104 | 0.928 |
Female (n = 333) | − 0.001 | 0.986 | 0.138 | 0.006 | 0.005 | 0.111 | 0.962 |
pf | 0.801 | 0.095 | |||||
Follow-up period | |||||||
Below median (n = 245) | − 0.018 | 0.756 | 0.035 | 0.560 | 0.352 | 0.067 | 0.862 |
Above median (n = 264) | 0.026 | 0.627 | 0.199 | < 0.001 | < 0.001 | 0.002 | 0.981 |
pg | 0.885 | 0.003 |
Joint effect of inflammation and insulin resistance on hyperglycemia
Independent variable | Outcome | |||||
---|---|---|---|---|---|---|
T2DM (37 vs 155) | Pre-T2DM (89 vs 155) | Hyperglycemia (126 vs 155) | ||||
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Black race | 1.14 (0.50–2.63) | 0.758 | 0.98 (0.51–1.90) | 0.953 | 1.07 (0.60–1.91) | 0.823 |
Female sex | 0.72 (0.30–1.73) | 0.467 | 0.39 (0.21–0.72) | 0.003 | 0.49 (0.28–0.84) | 0.010 |
Age | 1.05 (0.96–1.16) | 0.286 | 1.10 (1.02–1.17) | 0.010 | 1.08 (1.02–1.15) | 0.011 |
BMI | 1.07 (1.01–1.12) | 0.014 | 1.09 (1.05–1.14) | < 0.001 | 1.08 (1.04–1.12) | < 0.001 |
Smoking | 1.74 (0.71–4.25) | 0.224 | 1.17 (0.59–2.32) | 0.647 | 1.28 (0.70–2.34) | 0.419 |
Alcohol drinking | 0.30 (0.11–0.86) | 0.025 | 1.06 (0.57–1.96) | 0.855 | 0.77 (0.44–1.36) | 0.367 |
Groupa | 2.38 (1.06–5.33) | 0.035 | 2.27 (1.27–4.05) | 0.006 | 2.18 (1.30–3.64) | 0.003 |