Author Identifier (ORCID)
Dan Wu: https://orcid.org/0000-0002-9367-6557
Wei Wang: https://orcid.org/0000-0002-1430-1360
Abstract
Background Factors impacting on the conversion of prediabetes to diabetes or normoglycemia remain unclear. This study aimed to investigate the role of subclinical inflammation, assessed by high-sensitivity C-reactive protein (hsCRP), in the progression to diabetes from prediabetes, assessed by impaired fasting glucose (IFG). Methods Time-to-event survival analyses were conducted among 82 475 participants without diabetes from Kailuan Study (a real-life prospective cohort in China) to access the isolated and joint effect of hsCRP and IFG on diabetes risk, and quantify their relative contribution to incident diabetes. Results Over a median 11-year follow-up, 14 215 diabetes cases were recorded. IFG and hsCRP independently and jointly increased diabetes risk. Diabetes incidence was higher in those with elevated inflammation (hsCRP≥2 mg/L: 90.45 vs. 66.76 per 1000 person-years). The joint effect risk (hazard ratios (HR) = 4.96; 95% confidence interval (CI) = 4.66–5.28) exceeded the sum of individual risks (HR = 4.29; 95% CI = 4.09–4.49 for IFG and HR = 1.11; 95% CI = 1.06–1.16 for elevated inflammation), with a relative excess risk due to interaction of 0.56 (95% CI = 0.23–0.89). Attributable proportions were 83.08% for IFG, 2.78% for hsCRP, and 14.14% for their interaction. The joint risks and the additive interaction were significant in both men and women, and were more pronounced among individuals aged <60 years than those aged ≥60 years. Conclusions Elevated inflammation synergistically amplifies diabetes risk in prediabetes among Chinese adults, particularly in those <60 years.
Document Type
Journal Article
Date of Publication
1-1-2025
Volume
15
PubMed ID
41132049
Publication Title
Journal of Global Health
Publisher
University of Edinburgh
School
Centre for Precision Health / School of Medical and Health Sciences
Funders
Special Fund Project for Science and Technology Innovation Strategy of Guangdong Province (STKJ2023003, 202053-75, 202053-74)
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Lan, Y., Wu, D., Zheng, H., Ding, X., Zhou, H., Wu, K., Wu, W., Huang, Z., Wang, X., Wang, W., Wu, S., & Chen, Y. (2025). Elevated inflammation supra-additively promotes the progression from prediabetes to diabetes: A prospective cohort study. Journal of Global Health, 15, 04318. https://doi.org/10.7189/jogh.15.04318