title: Acute-phase serum amyloid A protein and its implication in the development of type 2 diabetes in the KORA S4/F4 study.
abstract: OBJECTIVE
  We sought to investigate whether elevated levels of acute-phase serum amyloid A (A-SAA) protein precede the onset of type 2 diabetes independently of other risk factors, including parameters of glucose metabolism.
  
  
  METHODS
  Within the population-based Cooperative Health Research in the Region of Augsburg (KORA) S4 study, we measured A-SAA concentrations in 836 initially nondiabetic subjects (55-74 years of age) without clinically overt inflammation who participated in a 7-year follow-up examination including an oral glucose tolerance test.
  
  
  RESULTS
  A-SAA concentrations were significantly associated with incident type 2 diabetes (odds ratio [OR] for a one-SD increase of A-SAA adjusted for age and sex = 1.28 [95% CI 1.08-1.53], P = 0.005), particularly in younger subjects (P value for interaction = 0.047). The association attenuated when adjusting for parameters of glucose metabolism (fasting glucose, fasting insulin, HbA1c, and 2-h glucose; OR 1.16 [0.95-1.42], P = 0.15). Similar analyses for high-sensitive C-reactive protein (hs-CRP) yielded the following ORs: 1.39 (1.10-1.68, P = 0.0006) and 1.13 (0.88-1.45, P = 0.34), respectively. In contrast, A-SAA concentrations were significantly associated with 2-h glucose levels at follow-up even after adjustment for parameters of glucose metabolism (P = 0.008, n = 803).
  
  
  CONCLUSIONS
  Our findings indicate similarly strong prospective associations with type 2 diabetes for A-SAA and hs-CRP and suggest a potential causal link via postchallenge hyperglycemia.
authors.affiliation: Department of Molecular Epidemiology, German Research Centerfor Environmental Health, Neuherberg, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Marzi
authors.forename: Cornelia
authors.initials: C
authors.lastname: Huth
authors.forename: Christian
authors.initials: C
authors.lastname: Herder
authors.forename: Jens
authors.initials: J
authors.lastname: Baumert
authors.forename: Barbara
authors.initials: B
authors.lastname: Thorand
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
authors.forename: H-Erich
authors.initials: HE
authors.lastname: Wichmann
authors.forename: Michael
authors.initials: M
authors.lastname: Roden
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Harald
authors.initials: H
authors.lastname: Grallert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Koenig
authors.forename: Thomas
authors.initials: T
authors.lastname: Illig
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D000685:Serum Amyloid A Protein / Q000378:metabolism*
chemical_list: D000685:Serum Amyloid A Protein