C-reactive protein and the risk of developing type 2 diabetes in Aboriginal Australians

Abstract

Objective To investigate the association between C-reactive protein (CRP) and the risk of developing diabetes in Aboriginal Australians. Research design and methods High sensitivity CRP levels were measured in 620 Aboriginal participants aged 20–74 years free from diabetes at baseline in a remote community in the Northern Territory of Australia. Participants were followed for a median of 11 years to identify newly diagnosed cases of diabetes. Cox proportional hazards models were used to assess the relationship of CRP levels with the risk of developing diabetes over the follow-up period. Results A total of 109 participants were newly diagnosed with diabetes. Incident rates were 10.8, 16.6 and 28.8 per 1000 person-years for people in the lower, middle and upper tertile groups of baseline CRP levels, respectively. After adjusting for age, sex, BMI, baseline glucose regulation status, total cholesterol, urine albumin to creatinine ratio, systolic blood pressure, smoking and alcohol drinking, the association between diabetes and CRP remained significant, with a hazard ratio of 1.23 (95% confidence interval (CI) 1.05, 1.45) corresponding to a doubling in CRP values. Similarly, the adjusted hazard ratio for development of diabetes in people in the upper tertile versus the bottom two tertiles of CRP was 1.75 (95% CI 1.19, 2.56). Conclusions CRP is independently associated with the development of diabetes in Aboriginal people. Our findings support a role of inflammation in the etiology of diabetes in the high risk population of Aboriginal Australians.