Risk of type 2 diabetes attributable to C-reactive protein and other risk factors.
OBJECTIVE
To calculate the population-attributable risk (PAR) of C-reactive protein (CRP) and other risk factors for type 2 diabetes.


METHODS
The Rotterdam Study is a population-based, prospective follow-up study among 7,983 participants aged > or = 55 years. Risk factors including serum CRP were determined at baseline. Participants with diabetes at baseline were excluded, and the cohort was followed for a mean of 10.8 years. The hazard ratio (HR) and PAR for diabetes were computed for all studied risk factors.


RESULTS
Serum CRP > 1 mg/l (HR 1.67, PAR 0.33), BMI > 25 kg/m2 (HR 2.51, PAR 0.51), waist circumference > 102 for men and > 88 cm for women (HR 1.36, PAR 0.14), current smoking (HR 1.16, PAR 0.03), age > 65 years (HR 1.35, PAR 0.15), and family history of diabetes (HR 1.87, PAR 0.16) were related to diabetes and contributed to the risk of the disease. Serum CRP was a greater contributor to the risk of diabetes in women than in men (PAR values of 0.37 vs. 0.28, respectively). Age and current smoking PARs were not statistically significantly contributing to the risk of diabetes in women. Combined PAR was 0.80 (95% CI 0.74-0.85) for all six studied risk factors and 0.71 (0.64-0.78) for modifiable risk factors (serum CRP, BMI, waist circumference, and current smoking).


CONCLUSIONS
High CRP is one of the major contributors to the risk of type 2 diabetes. The contribution of modifiable risk factors to the risk of diabetes is considerable.
Dehghan
Abbas
A
Department of Epidemiology and Biostatistics, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
van Hoek
Mandy
M
Sijbrands
Eric J G
EJ
Stijnen
Theo
T
Hofman
Albert
A
Witteman
Jacqueline C M
JC
D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D050177:Overweight; D018579:Patient Selection; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
D002097:C-Reactive Protein