Diabetes, hyperglycemia, and inflammation in older individuals: the health, aging and body composition study.
OBJECTIVE
The objective of this study was to assess the association of inflammation with hyperglycemia (impaired fasting glucose [IFG]/impaired glucose tolerance [IGT]) and diabetes in older individuals.


METHODS
Baseline data from the Health, Aging and Body Composition study included 3,075 well-functioning black and white participants, aged 70-79 years.


RESULTS
Of the participants, 24% had diabetes and 29% had IFG/IGT at baseline. C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) levels (P < 0.001) were significantly higher among diabetic participants and those with IFG/IGT. Odds of elevated IL-6 and TNF-alpha (>75th percentile) were, respectively, 1.95 (95% CI 1.56-2.44) and 1.88 (1.51-2.35) for diabetic participants and 1.51 (1.21-1.87) and 1.14 (0.92-1.42) for those with IFG/IGT after adjustment for age, sex, race, smoking, alcohol intake, education, and study site. Odds ratios for elevated CRP were 2.90 (2.13-3.95) and 1.45 (1.03-2.04) for diabetic women and men and 1.33 (1.07-1.69) for those with IFG/IGT regardless of sex. After adjustment for obesity, fat distribution, and inflammation-related conditions, IL-6 remained significantly related to both diabetes and IFG/IGT. CRP in women and TNF-alpha in both sexes were significantly related to diabetes, respectively, whereas risk estimates for IFG/IGT were decreased by adjustment for adiposity. Among diabetic participants, higher levels of HbA(1c) were associated with higher levels of all three markers of inflammation, but only CRP remained significant after full adjustment.


CONCLUSIONS
Our findings show that dysglycemia is associated with inflammation, and this relationship, although consistent in diabetic individuals, also extends to those with IFG/IGT.
de Rekeneire
Nathalie
N
Laboratory of Epidemiology, National Institute on Aging, Bethesda, MD 20892-9205, USA. rekenein@nia.nih.gov
Peila
Rita
R
Ding
Jingzhong
J
Colbert
Lisa H
LH
Visser
Marjolein
M
Shorr
Ronald I
RI
Kritchevsky
Stephen B
SB
Kuller
Lewis H
LH
Strotmeyer
Elsa S
ES
Schwartz
Ann V
AV
Vellas
Bruno
B
Harris
Tamara B
TB
D000368:Aged; D000375:Aging / Q000502:physiology*; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006262:Health; D006306:Health Surveys; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000453:epidemiology; D008297:Male
D015415:Biomarkers