Abstract
Our aim was to identify whether low-grade inflammation, reflected by C-reactive protein (CRP), explains the higher risk for incident type 2 diabetes (T2D) among ethnic minorities. We included 837 Dutch, 712 South-Asian Surinamese, 797 African Surinamese, 804 Ghanaian, 817 Turkish and 778 Moroccan origin participants of the HELIUS study (Amsterdam, the Netherlands). We used multiple linear regression to assess ethnic differences in CRP levels. We determined the association of CRP with T2D and the modifying effect of ethnicity by cox regression, and compared hazard ratios for the association between ethnicity and T2D before and after adjustment for CRP. CRP levels were higher in ethnic minority groups than in Dutch origin participants. CRP was associated with a higher T2D incidence, similarly across ethnic groups (overall HR per SD 1.38 [95% CI 1.14; 1.68]). However, the association was attenuated and no longer statistically significant after adjustment for adiposity measures (HR 1.11 [95% CI 0.90; 1.37]). CRP accounted for a very small part of the ethnic differences in T2D, but only in models unadjusted for adiposity. Low-grade inflammation does not substantially contribute to the higher risk of T2D among ethnic minority populations compared to the Dutch.
Highlights
Our aim was to identify whether low-grade inflammation, reflected by C-reactive protein (CRP), explains the higher risk for incident type 2 diabetes (T2D) among ethnic minorities
We investigated whether the association between CRP and T2D differed by ethnic origin by adding multiplicative interaction terms between CRP and ethnic groups in our models
Our study shows that CRP levels are higher among ethnic minority participants of South-Asian Surinamese, African Surinamese, Turkish and Moroccan origin than Dutch participants, but similar among Ghanaians, suggesting ethnic differences in low grade inflammation
Summary
Our aim was to identify whether low-grade inflammation, reflected by C-reactive protein (CRP), explains the higher risk for incident type 2 diabetes (T2D) among ethnic minorities. The incidence of type 2 diabetes (T2D) is 2–12 times higher in South-Asian and African populations compared to European populations[1,2] The causes of this increased risk have not been fully elucidated, but might be partly explained by higher levels of low-grade inflammation among ethnic minorities. The association has not yet been confirmed among high-risk South-Asian, African Surinamese, Ghanaian, Turkish and Moroccan origin populations. If CRP levels are found/confirmed to be high, low-grade inflammation may explain the increased risk for T2D among ethnic minorities. We describe differences in CRP levels between people of Dutch, Turkish, Moroccan, Ghanaian, South-Asian Surinamese and African Surinamese origin. We determined whether the increased risk for T2D among ethnic minorities were explained by higher levels of CRP
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