ASSOCIATION OF C-REACTIVE PROTEIN LEVEL WITH THE RISK OF TYPE 2 DIABETES: SYSTEMATIC REVIEW AND A DOSE-RESPONSE META-ANALYSIS

Abstract

Objective: The relationship between C-reactive protein (CRP) levels and the risk of type 2 diabetes were positive; however, the non-linearity pattern was still unknown. We conducted a systematic review and a dose-response meta-analysis to examine the association between CRP levels and the risk of diabetes and the dose-response curve pattern. Design and method: A comprehensive search was conducted in PubMed and Embase databases from the inception to March 7, 2023. We treated CRP as both a continuous and a categorical variable to analyze the risk ratio of incident diabetes. In addition, we performed a dose-response meta-analysis to explore the pattern of the dose-response curve, and a meta-regression analysis for potential effect modifiers. Results: A total of 17 studies with high study quality were collected. The CRP level as a continuous variable was associated with a 12% increase in the risk of diabetes [95% confidence interval (CI), 1.06-1.17] per 1 mg/L increase. The high-low comparison showed a significantly higher risk of 71% (95% CI, 1.42-2.06). The dose-response analysis showed a saturation curve pattern, suggesting a high risk among CRP levels within 5 mg/L. In addition, we found that smoking played a modest effect modifier for the association between CRP and diabetes risk (p, 0.11). Conclusions: We validated that a high CRP level was associated with the risk of diabetes, and the pattern was likely to be a saturation shape.