Abstract
IntroductionChronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes. Hyperglycemia is associated with chronic low-grade inflammation, and thus has become the focus of many screening and treatment recommendations. We hypothesize that insulin may also be associated with inflammation and may be an additional factor to consider in screening and treatment.MethodsThis study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). A two-part model was used due to the high number of values reported as 0.1 mg/L. Two models were analyzed, both with and without the addition of waist circumference to other covariates in the model.ResultsThe final sample included 4527 adults with a mean age of 43.31 years. In the first model, higher fasting insulin was associated with increased odds of CRP > 0.1 mg/L (OR = 1.02, p < .001) and with higher CRP (β = 0.03, p < .001). In the adjusted model, including waist circumference as a covariate, higher fasting insulin was not associated with CRP > 0.1 mg/L (OR = 1.00, p = .307) but the association between higher fasting insulin and higher continuous CRP remained significant (β = 0.01, p = .012).ConclusionThis study found that higher fasting insulin is associated with higher CRP. These results suggest that treatment approaches that simultaneously decrease insulin levels as well as glucose levels may provide additive anti-inflammatory effects, and therefore may improve long-term outcomes for adults with type 2 diabetes.
Highlights
MethodsThis study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP)
Chronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes
C-reactive protein (CRP) was associated with the markers of insulin resistance and fasting insulin among a nondiabetic population, and the relationship was attenuated after controlling for waist circumference [13]
Summary
This study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). Data on CRP, fasting insulin, obesity-related measurements and other characteristics were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2010, conducted by the National Center for Health Statistics (NCHS) in the Centers for Disease Control and Prevention. All the participants signed written consent, and the surveys were approved by the NCHS Institutional Review Board. Interviews and physical examinations were completed on a nationally representative sample of non-institutionalized individuals in the United States. A multi-stage sampling design with weighted domains was used to provide national estimates. Details of the sampling design and guidelines for the NHANES study have been described elsewhere [21]
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