Abstract
Purpose High sensitivity C-reactive protein (hs-CRP) has been used as a biomarker to assess the risk of cardiovascular accidents (CVA) and to measure general inflammation in the body. This study investigated the relationship and extent of correlation between serum glucose level markers and hs-CRP as a means to assess CVA risk through hemoglobin A1c (HbA1c) and fasting glucose levels. Methods This cross-sectional, population-based study used data from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). From the total sample of 8,127 people, 4,590 subjects were excluded due to age (<19 years) (n = 1,505), diabetes mellitus (DM) diagnosis or medication (n = 596), inactivity (n = 424), pregnancy (n = 17), hypoglycemia (<70 mg/dL) (n = 8), smoking history (n = 1,077), and missing data (n = 963). In total, 3,537 adults not diagnosed with diabetes were selected. Their hs-CRP levels were compared with the glucose level markers using a complex sample general linear regression analysis. Results We adjusted for sedentary hours, smoking, binge drinking frequency, age, sex, mean SBP, triglycerides, and waist circumference. Increases in HbA1c correlated with hs-CRP levels (B coefficient (95%CI) = 0.185, p = 0.001, and R2 = 0.087). Changes in the fasting glucose levels were also associated with the hs-CRP levels (B coefficient (95%CI) = 0.005, p = 0.006, and R2 = 0.086). Conclusion This study showed a linear association between HbA1c and fasting glucose levels and hs-CRP. It also showed that changes in the hs-CRP level were better correlated with those in the HbA1c levels than in the fasting glucose levels.
Highlights
C-reactive protein (CRP) is an acute-phase reactant, and its circulating concentration rises rapidly as a cytokinemediated response to tissue injury, infection and inflammation [1]
Hs-CRP, hemoglobin A1c (HbA1c), fasting glucose, age, waist circumference, mean systolic blood pressure, daily sedentary hours, triglycerides, and white blood cell (WBC) count were measured as continuous variables, while gender, binge drinking frequency, and smoking were considered as nominal variables
Participants’ basal characteristics are shown in Table 1. high sensitivity-CRP (hs-CRP) and fasting glucose levels were higher in males than in females, and the differences were statistically significant (p < 0:05)
Summary
C-reactive protein (CRP) is an acute-phase reactant, and its circulating concentration rises rapidly as a cytokinemediated response to tissue injury, infection and inflammation [1]. Some studies have suggested that higher CRP levels are associated with increased risk of a cardiovascular event [4]. HbA1c levels show concentration-dependent elevation with the increase in cardiovascular risk. Fasting glucose levels above and below certain limits are associated with increased risk of a cardiovascular event [8]. Some studies have examined the relationship between HbA1c, fasting glucose, and hs-CRP in diabetic patients [9], but this association has rarely been studied in undiagnosed diabetes cases in Korea. The current study was conducted to determine whether HbA1c and fasting glucose levels correlate with hs-CRP in Koreans with undiagnosed diabetes, as well as to determine which of these parameters better reflects cardiovascular risk
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