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Association between Inflammatory Markers and Glycemic Control in Korean Diabetic Patients

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Objectives: This study evaluated the association between inflammatory markers and glycemic control in Korean patients with diabetes mellitus. Methods: Using data from the 2007-2018 Korean National Health and Nutritional Examination, 4,186 diabetic subjects aged between 19 and 80 years were included in this study. Poor glycemic control was defined as level of HbA1c higher than 7%. Inflammation was measured by inflammatory markers including white blood cell (WBC) count and high-sensitivity C-reactive protein (hsCRP), and those inflammatory markers were categorized into 4 groups by quartiles. A multiple logistic regression analysis was performed to evaluate the association between quartile of inflammatory markers and poor glycemic control after adjusting for demographic factors, lifestyle, and comorbidities. Results: Levels of WBC count and hsCRP were positively associated with the risk of poor glycemic control even after fully adjusting for potential confounders. For WBC count, compared with the first quartile, the second quartile was 1.50 (95% confidence interval, CI: 1.26-1.78), 1.71 (95 % CI:1.43-2.05) for the third, 2.00 (95% CI: 1.67-2.40) for the fourth. In case of hsCRP, compared with the first quartile, the second quartile was 1.15 (95% CI: 0.87-1.53), 1.59 (95% CI: 1.20-2.11) for the third, and 1.59 (95% CI: 1.19-2.12) for the fourth. There was significant age difference in the association between hsCRP and glycemic control. The association was more evident in the younger group than in the elderly group. Conclusions: High level of WBC and hsCRP were positively associated with the risk of poor glycemic control. These results suggest that in a Korean diabetic patient, inflammation was significantly associated with poor glycemic control

Abstract

Objectives: This study evaluated the association between inflammatory markers and glycemic control in Korean patients with diabetes mellitus. Methods: Using data from the 2007-2018 Korean National Health and Nutritional Examination, 4,186 diabetic subjects aged between 19 and 80 years were included in this study. Poor glycemic control was defined as level of HbA1c higher than 7%. Inflammation was measured by inflammatory markers including white blood cell (WBC) count and high-sensitivity C-reactive protein (hsCRP), and those inflammatory markers were categorized into 4 groups by quartiles. A multiple logistic regression analysis was performed to evaluate the association between quartile of inflammatory markers and poor glycemic control after adjusting for demographic factors, lifestyle, and comorbidities. Results: Levels of WBC count and hsCRP were positively associated with the risk of poor glycemic control even after fully adjusting for potential confounders. For WBC count, compared with the first quartile, the second quartile was 1.50 (95% confidence interval, CI: 1.26-1.78), 1.71 (95 % CI:1.43-2.05) for the third, 2.00 (95% CI: 1.67-2.40) for the fourth. In case of hsCRP, compared with the first quartile, the second quartile was 1.15 (95% CI: 0.87-1.53), 1.59 (95% CI: 1.20-2.11) for the third, and 1.59 (95% CI: 1.19-2.12) for the fourth. There was significant age difference in the association between hsCRP and glycemic control. The association was more evident in the younger group than in the elderly group. Conclusions: High level of WBC and hsCRP were positively associated with the risk of poor glycemic control. These results suggest that in a Korean diabetic patient, inflammation was significantly associated with poor glycemic control

참고문헌 (52)

  1. Kweon S, "Data resource profile : the Korea National Health and Nutrition Examination Survey(KNHANES)", Int J Epidemiol, 43(1), pp.69~77 (2014)[DOI]
  2. Indicators O, "Health at a Glance" (2015), OECD Publishing Paris
  3. Bommer C, "Global economic burden of diabetes in adults : projections from 2015 to 2030", Diabetes Care, 41(5), pp.963~970 (2018)[DOI]
  4. Park JH, "Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans : the fifth Korea National Health and Nutrition Examination Survey(KNHANES V)", J Phys Ther Sci, 27(11), pp.3559~3564 (2015)[DOI]
  5. Deshpande AD, "Epidemiology of diabetes and diabetes-related complications", Phys Ther, 88(11), pp.1254~1264 (2008)[DOI]
  6. de Morais PK, "Effects of aerobic exercise intensity on 24-h ambulatory blood pressure in individuals with type 2 diabetes and prehypertension", J Phys Ther Sci, 27(1), pp.51~56 (2015)[DOI]
  7. Alsenany S, "Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center", J Phys Ther Sci, 27(6), pp.1727~1730 (2015)[DOI]
  8. Fasil A, "Glycemic control and diabetes complications among diabetes mellitus patients attending at University of Gondar Hospital, Northwest Ethiopia", Diabetes Metab Syndr Obes, 12, pp.75~83 (2018)[DOI]
  9. Stolar M, "Glycemic control and complications in type 2 diabetes mellitus", Am J Med, 123(3 Suppl), pp.S3~S11 (2010)[DOI]
  10. Vozarova B, "High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes", Diabetes, 51(2), pp.455~461 (2002)[DOI]
  11. Bastard JP, "Recent advances in the relationship between obesity, inflammation, and insulin resistance", Eur Cytokine Netw, 17(1), pp.4~12 (2006)
  12. Pradhan AD, "C-reactive protein is independently associated with fasting insulin in nondiabetic women", Arterioscler Thromb Vasc Biol, 23(4), pp.650~655 (2003)[DOI]
  13. Shoelson SE, "Inflammation and insulin resistance", J Clin Invest, 116(7), pp.1793~1801 (2006)[DOI]
  14. van Greevenbroek MM, "Obesity-associated low-grade inflammation in type 2 diabetes mellitus : causes and consequences", Neth J Med, 71(4), pp.174~187 (2013)
  15. León-Pedroza JI, "Low-grade systemic inflammation and the development of metabolic diseases : from the molecular evidence to the clinical practice", Cir Cir, 83(6), pp.543~551 (2015)[DOI]
  16. Pitsavos C, "Association between low-grade systemic inflammation and type 2 diabetes mellitus among men and women from the ATTICA study", Rev Diabet Stud, 4(2), pp.98~104 (2007)[DOI]
  17. Pradhan AD, "C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus", JAMA, 286(3), pp.327~334 (2001)[DOI]
  18. Liu S, "Association between inflammation and biological variation in hemoglobin A1c in U. S. nondiabetic adults", J Clin Endocrinol Metab, 100(6), pp.2364~2371 (2015)[DOI]
  19. Kizilgul M, "Components of the complete blood count in type 2 diabetes mellitus with inadequate glycemic control", Dicle Tıp Dergisi, 45(2), pp.113~120 (2018)[DOI]
  20. Duncan BB, "Low-grade systemic inflammation and the development of type 2 diabetes : the atherosclerosis risk in communities study", Diabetes, 52(7), pp.1799~1805 (2003)[DOI]
  21. Barzilay JI, "The relation of markers of inflammation to the development of glucose disorders in the elderly : the Cardiovascular Health Study", Diabetes, 50(10), pp.2384~2389 (2001)[DOI]
  22. 오예진, "제2형 당뇨 환자에서 혈당조절 효과에 대한 혈액학적 지표", Laboratory Medicine Online, 6(3), pp.134~139 (2016), 대한진단검사의학회
  23. 홍재원, "Association between White Blood Cell Counts within Normal Range and Hemoglobin A1c in a Korean Population", Endocrinology and Metabolism, 33(1), pp.79~87 (2018), 대한내분비학회
  24. Bentley DW, "Practice guideline for evaluation of fever and infection in long-term care facilities", J Am Geriatr Soc, 49(2), pp.210~222 (2001)[DOI]
  25. Kanmani S, "Association of C-reactive protein with risk of developing type 2 diabetes mellitus, and role of obesity and hypertension : A large population-based Korean cohort study", Sci Rep, 9(1), pp.4573~ (2019)[DOI]
  26. Zalli A, "Lowgrade inflammation predicts persistence of depressive symptoms", Psychopharmacology(Berl), 233(9), pp.1669~1678 (2016)[DOI]
  27. George EL, "Does a high WBC count signal infection?", Nursing, 35(1), pp.20~21 (2005)[DOI]
  28. American Diabetes Association, "Diagnosis and classification of diabetes mellitus", Diabetes Care, 37(Suppl 1), pp.S81~S90 (2014)[DOI]
  29. World Health Organization, "The global prevalence of anaemia in 2011" (2015), World Health Organization
  30. Lee YJ, "Elevated white blood cell count is associated with arterial stiffness", Nutr Metab Cardiovasc Dis, 19(1), pp.3~7 (2009)[DOI]
  31. Lin F, "High-sensitivity C-reactive protein as an indicator of ischemic stroke in patients with isolated acute vestibular syndrome : Retrospective observational study", Medicine(Baltimore), 98(48), pp.e18097~ (2019)[DOI]
  32. 구현경, "Systemic White Blood Cell Count as a Biomarker Associated with Severity of Chronic Obstructive Lung Disease", Tuberculosis and Respiratory Diseases, 80(3), pp.304~310 (2017), 대한결핵및호흡기학회
  33. Zhang H, "White blood cell subtypes and risk of type 2 diabetes", J Diabetes Complications, 31(1), pp.31~37 (2017)[DOI]
  34. Sefil F, "Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus", J Int Med Res, 42(2), pp.581~588 (2014)[DOI]
  35. King DE, "C-reactive protein and glycemic control in adults with diabetes", Diabetes Care, 26(5), pp.1535~1539 (2003)[DOI]
  36. Huffman FG, "Relationship between glycemic control and C-reactive protein in Cuban-Americans with type 2 diabetes mellitus", The FASEB Journal, 22(51), pp.1098.3~1098.3 (2008)[DOI]
  37. de Rekeneire N, "Diabetes, hyperglycemia, and inflammation in older individuals : the health, aging and body composition study", Diabetes Care, 29(8), pp.1902~1908 (2006)[DOI]
  38. Milosevic D, "Relationship between hematological parameters and glycemic control in type 2 diabetes mellitus patients", J Med Biochem, 38(2), pp.164~171 (2019)[DOI]
  39. Nada AM, "Red cell distribution width in type 2 diabetic patients", Diabetes Metab Syndr Obes, 8, pp.525~533 (2015)[DOI]
  40. Klein NJ, "Alteration in glycosaminoglycan metabolism and surface charge on human umbilical vein endothelial cells induced by cytokines, endotoxin and neutrophils", J Cell Sci, 102(Pt 4), pp.821~832 (1992)
  41. Pickup JC, "NIDDM as a disease of the innate immune system : association of acute-phase reactants and interleukin-6 with metabolic syndrome X", Diabetologia, 40(11), pp.1286~1292 (1997)[DOI]
  42. Blake GJ, "Tumour necrosis factor-alpha, inflammatory biomarkers, and atherogenesis", Eur Heart J, 23(5), pp.345~347 (2002)[DOI]
  43. Chen L, "Mechanisms linking inflammation to insulin resistance", Int J Endocrinol, 2015, pp.508409~ (2015)[DOI]
  44. Ross R, "Atherosclerosis-an inflammatory disease", N Engl J Med, 340(2), pp.115~126 (1999)[DOI]
  45. Wieser V, "Inflammation, cytokines and insulin resistance : a clinical perspective", Arch Immunol Ther Exp(Warsz), 61(2), pp.119~125 (2013)[DOI]
  46. de Luca C, "Inflammation and insulin resistance", FEBS Lett, 582(1), pp.97~105 (2008)[DOI]
  47. 하경화, "Trends in the Diabetes Epidemic in Korea", Endocrinology and Metabolism, 30(2), pp.142~146 (2015), 대한내분비학회
  48. Sindhu S, "Obesity is a positive modulator of IL-6R and IL-6 expression in the subcutaneous adipose tissue : Significance for metabolic inflammation", PLoS One, 10(7), pp.e0133494~ (2015)[DOI]
  49. Incio J, "Obesity promotes resistance to anti-VEGF therapy in breast cancer by up-regulating IL-6 and potentially FGF-2", Sci Transl Med, 10(432), pp.eaag0945~ (2018)[DOI]
  50. Saraheimo M, "Diabetic nephropathy is associated with low-grade inflammation in Type 1 diabetic patients", Diabetologia, 46(10), pp.1402~1407 (2003)[DOI]
  51. Oda E, "High-sensitivity C-reactive protein, but not white blood cell count, independently predicted incident diabetes in a Japanese health screening population", Acta Diabetol, 52(2), pp.983~990 (2015)[DOI]
  52. Twig G, "White blood cells count and incidence of type 2 diabetes in young men", Diabetes Care, 36(2), pp.276~282 (2013)[DOI]

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