title: Profile of the Immune and Inflammatory Response in Individuals With Prediabetes and Type 2 Diabetes.
abstract: OBJECTIVE
  The inflammatory and immune systems are altered in type 2 diabetes. Here, the aim was to profile the immune and inflammatory response in subjects with prediabetes and diabetes in a large population-representative sample.
  
  
  METHODS
  In total, 15,010 individuals were analyzed from the population-based Gutenberg Health Study. Glucose status was classified according to HbA1c concentration and history of diagnosis. All samples were analyzed for white blood cells (WBCs), granulocytes, lymphocytes, monocytes, platelets, C-reactive protein (CRP), albumin, fibrinogen, and hematocrit. Interleukin-18 (IL-18), IL-1 receptor antagonist (IL-1RA), and neopterin concentrations were determined in a subcohort.
  
  
  RESULTS
  In total, 7,584 men and 7,426 women were analyzed (range 35-74 years), with 1,425 and 1,299 having prediabetes and diabetes, respectively. Biomarkers showed varying dynamics from normoglycemic via subjects with prediabetes to subjects with diabetes: 1) gradual increase (WBCs, granulocytes, monocytes, IL-1RA, IL-18, and fibrinogen), 2) increase with subclinical disease only (lymphocytes and CRP), 3) increase from prediabetes to diabetes only (neopterin), and 4) no variation with glucose status (hematocrit). The strongest relative differences were found for CRP, IL-1RA, and fibrinogen concentrations. Several inflammatory and immune markers were associated with the glucose status independent from cardiovascular risk factors and comorbidities, varied with disease severity and the presence of disease-specific complications in the diabetes subcohort.
  
  
  CONCLUSIONS
  The inflammatory and immune biomarker profile varies with the development and progression of type 2 diabetes. Markers of inflammation and immunity enable differentiation between the early preclinical and clinical phases of the disease, disease complications, and progression.
authors: Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.
authors: Vera
authors: V
authors: Grossmann
authors: Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Volker H
authors: VH
authors: Schmitt
authors: Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, Lübeck, Kiel, Germany.
authors: Tanja
authors: T
authors: Zeller
authors: Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.
authors: Marina
authors: M
authors: Panova-Noeva
authors: Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Andreas
authors: A
authors: Schulz
authors: Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Dagmar
authors: D
authors: Laubert-Reh
authors: Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Claus
authors: C
authors: Juenger
authors: Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, Lübeck, Kiel, Germany.
authors: Renate B
authors: RB
authors: Schnabel
authors: Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Tobias G J
authors: TG
authors: Abt
authors: Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Rafael
authors: R
authors: Laskowski
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
authors: Jörg
authors: J
authors: Wiltink
authors: Department of Medicine 2, University Medical Center Mainz, Mainz, Germany.
authors: Eberhard
authors: E
authors: Schulz
authors: Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, Lübeck, Kiel, Germany.
authors: Stefan
authors: S
authors: Blankenberg
authors: Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany.
authors: Karl J
authors: KJ
authors: Lackner
authors: Department of Medicine 2, University Medical Center Mainz, Mainz, Germany German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
authors: Thomas
authors: T
authors: Münzel
authors: Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany Preventive Cardiology and Preventive Medicine, Department of Medicine 2, University Medical Center Mainz, Mainz, Germany German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany philipp.wild@unimedizin-mainz.de.
authors: Philipp S
authors: PS
authors: Wild
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007109:Immunity; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein