The relation of markers of inflammation to the development of glucose disorders in the elderly - The cardiovascular health study

Several studies suggest that inflammation plays a role in the pathogenesis of some glucose disorders in adults. We tested this hypothesis in a longitu dinal cohort study of older individuals who had normal fasting glucose (FG) values at baseline. We compared the baseline levels of six inflammatory ma rkers in participants who had developed glucose disorders at follow-up with those of participants whose FG remained normal at follow-up. Participants were members of the Cardiovascular Health Study, a prospective study of ris k factors for cardiovascular disease in adults greater than or equal to 65 years. All 5,888 participants had baseline testing, including FG and marker s of inflammation: white blood cell and platelet counts and albumin, fibrin ogen, C-reactive protein (CRP), and factor VIIIc levels. At 3-4 years of fo llow-up, 4,481 (84.5%) of those who were alive had FG levels retested. Part icipants who developed diabetes (n = 45) had higher median levels of CRP at baseline than those who remained normoglycemic. On multivariate analysis, those with elevated CRP levels (75th percentile [2.86 mg/l] vs. 25th percen tile [0.82 mg/l]) were 2.03 times (95% confidence intervals, 1.44-2.86) mor e likely to have diabetes on follow-up. Adjustment for confounders and othe r inflammatory markers did not appreciably change this finding. There was n o relationship between the development of diabetes and other markers of inf lammation. Inflammation, as measured by CRP levels, is associated with the development of diabetes in the elderly. Understanding the role of inflammat ion in the pathogenesis of glucose disorders in this age-group may lead to better classification and treatment of glucose disorders among them.