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Diabetes 50:2384-2389, 2001
© 2001 by the American Diabetes Association, Inc.

The Relation of Markers of Inflammation to the Development of Glucose Disorders in the Elderly

The Cardiovascular Health Study

Joshua I. Barzilay1, Linn Abraham2, Susan R. Heckbert3, Mary Cushman4, Lewis H. Kuller5, Helaine E. Resnick6, and Russell P. Tracy7

1 Division of Endocrinology, Kaiser Permanente of Georgia, and the Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia
2 Department of Biostatistics, University of Washington, Seattle, Washington
3 Department of Epidemiology, University of Washington, Seattle, Washington
4 Department of Medicine, University of Vermont College of Medicine, Colchester, Vermont
5 Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
6 Medstar Research Institute, Washington, D.C.
7 Department of Pathology, University of Vermont College of Medicine, Colchester, Vermont

Several studies suggest that inflammation plays a role in the pathogenesis of some glucose disorders in adults. We tested this hypothesis in a longitudinal cohort study of older individuals who had normal fasting glucose (FG) values at baseline. We compared the baseline levels of six inflammatory markers in participants who had developed glucose disorders at follow-up with those of participants whose FG remained normal at follow-up. Participants were members of the Cardiovascular Health Study, a prospective study of risk factors for cardiovascular disease in adults >=65 years. All 5,888 participants had baseline testing, including FG and markers of inflammation: white blood cell and platelet counts and albumin, fibrinogen, C-reactive protein (CRP), and factor VIIIc levels. At 3–4 years of follow-up, 4,481 (84.5%) of those who were alive had FG levels retested. Participants who developed diabetes (n = 45) had higher median levels of CRP at baseline than those who remained normoglycemic. On multivariate analysis, those with elevated CRP levels (75th percentile [2.86 mg/l] vs. 25th percentile [0.82 mg/l]) were 2.03 times (95% confidence intervals, 1.44–2.86) more likely to have diabetes on follow-up. Adjustment for confounders and other inflammatory markers did not appreciably change this finding. There was no relationship between the development of diabetes and other markers of inflammation. Inflammation, as measured by CRP levels, is associated with the development of diabetes in the elderly. Understanding the role of inflammation in the pathogenesis of glucose disorders in this age-group may lead to better classification and treatment of glucose disorders among them.


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