title: C-reactive protein is more strongly related to post-glucose load glucose than to fasting glucose in non-diabetic subjects; the Insulin Resistance Atherosclerosis Study.
abstract: OBJECTIVE
  It has been suggested that cardiovascular disease may be more strongly related to post-challenge glycaemia than to fasting glucose concentrations. We hypothesized that subclinical inflammation, as indicated by elevated serum levels of C-reactive protein (CRP), may partially explain the association of cardiovascular disease with post-challenge glycaemia.
  
  
  METHODS
  We studied the relationship of CRP (measured with a highly sensitive immunoassay) with fasting glucose and 2-h glucose concentrations during an oral glucose tolerance test in non-diabetic subjects from the Insulin Resistance Atherosclerosis Study.
  
  
  RESULTS
  Spearman correlation analyses and multiple linear regression analyses showed a significant association of both fasting glucose and 2-h glucose concentrations with CRP levels, after adjusting for demographic covariates (age, sex, ethnicity, clinical centre; Spearman correlation coefficients: r = 0.18 for fasting glucose, r = 0.27 for 2-h glucose, both P < 0.0001). However, after additional adjustment for body mass index and waist-hip ratio only 2-h glucose (and not fasting glucose) was significantly related to CRP (r = 0.03 for fasting glucose, P = NS; r = 0.14 for 2-h glucose, P < 0.0001). Adding insulin sensitivity to the multivariate models further weakened the relationship of CRP to 2-h glucose (r = 0.07, P < 0.05). CRP mean values increased by 2-h glucose category (normal vs. impaired glucose tolerance vs. isolated post-challenge hyperglycaemia).
  
  
  CONCLUSIONS
  Chronic, subclinical inflammation, as indicated by elevated circulating CRP levels, is more strongly associated with post-challenge glycaemia than with fasting glucose levels in non-diabetic subjects. This association is partially independent of body fat and insulin resistance.
authors.affiliation: Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78228-3900, USA.
authors.forename: A
authors.initials: A
authors.lastname: Festa
authors.forename: R
authors.initials: R
authors.lastname: D'Agostino
authors.forename: R P
authors.initials: RP
authors.lastname: Tracy
authors.forename: S M
authors.initials: SM
authors.lastname: Haffner
mesh_terms: D000273:Adipose Tissue; D001161:Arteriosclerosis / Q000097:blood / Q000209:etiology*; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein