title: Unfavorable inflammatory profile in adults at risk of type 2 diabetes identified by hemoglobin A1c levels according to the American Diabetes Association criteria.
abstract: OBJECTIVE
  We aimed to evaluate the inflammatory profile of individuals with prediabetes defined by HbA1c levels, according to the new American Diabetes Association criteria, and to determine the ability of HbA1c to identify individuals with subclinical inflammation independently of the contribution of other metabolic parameters such as fasting, 1- or 2-h post-load glucose (PG) levels.
  
  
  METHODS
  High sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), fibrinogen, white blood cells (WBC) count and complement C3 (C3) were assessed, and oral glucose tolerance test (OGTT) was performed in 711 adults.
  
  
  RESULTS
  Subjects were stratified into three groups according to their HbA1c levels. Poor agreement existed between HbA1c and 2-h PG criteria for identification of individuals with prediabetes (κ coefficient = 0.300). As compared with subjects having HbA1c <5.7 % (39 mmol/mol), individuals with prediabetes (HbA1c 5.7-6.4 %, [39-46 mmol/mol]) exhibited a significant increase of the concentration of five inflammatory markers (hsCRP, ESR, fibrinogen, WBC count, C3) as well as of a cluster of inflammatory markers, as measured by an inflammatory score after adjusting for sex, age, smoking, fasting, 1- and 2-h PG levels. In multiple regression models including sex, age, body mass index, smoking habit, fasting, 1- and 2-h PG levels, and HOMA index, HbA1c levels were significant independent contributors to each of the five inflammatory markers examined.
  
  
  CONCLUSIONS
  These data suggest that HbA1c is a reliable marker of glucose homeostasis, and may identify individuals at increased risk of diabetes with unfavorable inflammatory profile independently from fasting and 2-h PG levels.
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
authors.forename: T V
authors.initials: TV
authors.lastname: Fiorentino
authors.forename: M L
authors.initials: ML
authors.lastname: Hribal
authors.forename: M
authors.initials: M
authors.lastname: Perticone
authors.forename: F
authors.initials: F
authors.lastname: Andreozzi
authors.forename: A
authors.initials: A
authors.lastname: Sciacqua
authors.forename: F
authors.initials: F
authors.lastname: Perticone
authors.forename: G
authors.initials: G
authors.lastname: Sesti
mesh_terms: D000328:Adult; D000368:Aged; D000574:American Medical Association; D001244:Association; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000276:immunology*; D003176:Complement C3 / Q000276:immunology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000382:microbiology*; D005260:Female; D005340:Fibrinogen / Q000276:immunology; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000276:immunology; D014481:United States
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D003176:Complement C3; D005340:Fibrinogen; D006442:Glycated Hemoglobin