ArticleJournal of global health2025
Elevated inflammation supra-additively promotes the progression from prediabetes to diabetes: a prospective cohort study.
Article in Journal of global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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