Acute inflammation amplifies the diabetogenic effect of excess adiposity: Evidence from a real-life, prospective cohort

Abstract

Aims: Mounting evidence has suggested the probable involvement of infections in obesity-associated type 2 diabetes. This study aims to evaluate the association between acute inflammation and type 2 diabetes risk and to examine whether this association is modified by adiposity status. Materials and Methods: This study analysed 82 314 participants without pre-existing diabetes from a real-life, prospective cohort in China. Acute immune response was defined as high-sensitivity C-reactive protein (hsCRP) ≥10 mg/L, and overweight/obesity as body mass index (BMI) ≥24 kg/m2. Multivariable Cox regression models estimated diabetes risk, and both multiplicative and additive interactions were evaluated. Results: During a median follow-up of 11 years, 14 189 participants developed diabetes. Both elevated hsCRP and overweight/obesity independently increased diabetes risk. Acute inflammation was associated with a higher diabetes risk [hazard ratio (HR): 1.14; 95% confidence interval (CI): 1.04–1.22], particularly among those with excess adiposity [HR: 1.24 (1.13–1.36)] compared to those with normal weight [HR: 1.00 (0.83–1.21); P-interaction = 0.0112]. A supra-additive interaction was observed (relative excess risk due to interaction: 0.27; 95% CI: 0.02–0.52), with stronger synergistic effects seen in individuals under 60 and differences noted by sex. Conclusions: Acute inflammation significantly elevates diabetes risk in overweight/obese individuals but not in those with normal weight, highlighting the synergistic role of adiposity and immune activation in diabetes pathogenesis and the importance of weight control in prevention strategies.

Document Type

Journal Article

Date of Publication

1-1-2025

PubMed ID

41190364

Publication Title

Diabetes, Obesity and Metabolism

Publisher

Wiley

School

Centre for Precision Health / School of Medical and Health Sciences

RAS ID

84626

Funders

Guangdong Medical Research Foundation (B2025348, B2025601) / Special Fund Project for Science and Technology Innovation Strategy of Guangdong Province (STKJ2023003)

Comments

Lan, Y., Wu, D., Feng, B., Ding, X., Xu, L., Zheng, H., Wu, K., Li, X., Balmer, L., Wang, W., Wu, S., & Chen, Y. (2025). Acute inflammation amplifies the diabetogenic effect of excess adiposity: Evidence from a real‐life, prospective cohort. Diabetes, Obesity and Metabolism. Advance online publication. https://doi.org/10.1111/dom.70274

Copyright

subscription content

Link to Full Text

Share

 
COinS
 

Link to publisher version (DOI)

10.1111/dom.70274