Thorand Barbara, Löwel Hannelore, Schneider Andrea, Kolb Hubert, Meisinger Christa, Fröhlich Margit, Koenig Wolfgang
GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
Arch Intern Med. 2003 Jan 13;163(1):93-9. doi: 10.1001/archinte.163.1.93.
Previous studies have suggested that low-grade systemic inflammation is involved in the pathogenesis of type 2 diabetes mellitus.
To investigate the association between C-reactive protein (CRP), the classic acute-phase protein, and incident type 2 diabetes mellitus among middle-aged men.
A total of 2052 initially nondiabetic men aged 45 to 74 years who participated in 1 of the 3 MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Augsburg surveys between 1984 and 1995 were followed up for an average of 7.2 years. Incidence of diabetes was assessed by questionnaire mailed to participants in 1998. High-sensitive CRP was measured by an immunoradiometric assay.
A total of 101 cases of incident diabetes occurred during the follow-up period. The age-standardized incidence rate was 6.9 per 1000 person-years. Men with CRP levels in the highest quartile (CRP > or = 2.91 mg/L) had a 2.7 times higher risk of developing diabetes (95% confidence interval, 1.4-5.2) compared with men in the lowest quartile (CRP < or = 0.67 mg/L) in a Cox proportional hazards model adjusted for age and survey. After further adjustment for body mass index, smoking, and systolic blood pressure, the observed association was significantly reduced and became nonsignificant.
Low-grade systemic inflammation is associated with an increased risk of type 2 diabetes mellitus in middle-aged men. Inflammation could be one mechanism by which known risk factors for diabetes mellitus, such as obesity, smoking, and hypertension, promote the development of diabetes mellitus.
既往研究提示，低度全身炎症参与2型糖尿病的发病机制。
探讨经典急性期蛋白C反应蛋白（CRP）与中年男性2型糖尿病发病之间的关联。
对1984年至1995年间参加3项奥格斯堡心血管疾病趋势和决定因素监测（MONICA）调查之一的2052名年龄在45至74岁的初发非糖尿病男性进行平均7.2年的随访。通过1998年邮寄给参与者的问卷评估糖尿病发病率。采用免疫放射分析测定高敏CRP。
随访期间共发生101例糖尿病。年龄标准化发病率为每1000人年6.9例。在按年龄和调查进行校正的Cox比例风险模型中，CRP水平处于最高四分位数（CRP≥2.91mg/L）的男性患糖尿病的风险是处于最低四分位数（CRP≤0.67mg/L）男性的2.7倍（95%置信区间，1.4 - 5.2）。在进一步校正体重指数、吸烟和收缩压后，观察到的关联显著降低且变得不显著。
低度全身炎症与中年男性2型糖尿病风险增加相关。炎症可能是肥胖、吸烟和高血压等已知糖尿病危险因素促进糖尿病发生发展的一种机制。
