Chronic inflammation role in the obesity-diabetes association: a case-cohort study

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  • Luft, Vivian C
    • Other Affiliation: Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
  • Schmidt, Maria I
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
    • Other Affiliation: Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
  • Pankow, James S
    • Other Affiliation: Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
  • Couper, David
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Ballantyne, Christie M
    • Other Affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX, United States of America
  • Young, J
    • Other Affiliation: Departments of Medicine and Epidemiology, The Johns Hopkins University, Baltimore, MD, United States of America
  • Duncan, Bruce B
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
    • Other Affiliation: Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
Abstract
  • Abstract: Background: Chronic inflammation is related to both obesity and diabetes. Our aim was to investigate to what extent this inflammation contributes to the association between obesity and diabetes. Methods: Using a case-cohort design, we followed 567 middle-aged individuals who developed diabetes and 554 who did not over 9 years within the ARIC Study. Weighted Cox proportional hazards analyses permitted statistical inference to the entire cohort. Results: Obese individuals (BMI≥30 kg/m2), compared to those with BMI<25 kg/m2, presented a large increased risk of developing diabetes (HR[obesity]=6.4, 95%CI 4.5–9.2), as did those in the highest (compared to the lowest) quartile of waist circumference (HR[waist]=8.3, 95%CI 5.6–12.3), in analyses adjusted for age, gender, ethnicity, study center, and parental history of diabetes. Notably, further adjustment for adiponectin and inflammation markers halved the magnitude of these associations (HR[obesity]=3.2, 95%CI 2.1–4.7; and HR[waist]=4.2, 95%CI 2.8–6.5). In similar modeling, attenuation obtained by adding fasting insulin, instead of these markers, was only slightly more pronounced HR[obesity]=2.7, 95%CI 1.7–4.1; and HR[waist]=3.6, 95%CI 2.3–5.8). Conclusions: The marked decrease in the obesity-diabetes association after taking into account inflammation markers and adipokines indicates their major role in the pathways leading to adult onset of diabetes in obese individuals.
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  • Article
Rights statement
  • In Copyright
Rights holder
  • Vivian C Luft et al.; licensee BioMed Central Ltd.
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Journal title
  • Diabetology & Metabolic Syndrome
Journal volume
  • 5
Journal issue
  • 1
Page start
  • 31
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1758-5996
Bibliographic citation
  • Diabetology & Metabolic Syndrome. 2013 Jun 27;5(1):31
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • July 1, 2013

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