The effect of intensive risk factor management in type 2 diabetes on inflammatory biomarkers

Xanthia F. Samaropoulos, Laney Light, Walter T. Ambrosius, Santica M. Marcovina, Jeffrey Probstfield, David C. Goff

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Aims: To determine whether intensive risk factor management reduced markers of inflammation in middle-aged and older people with type 2 diabetes who either had, or were at risk for cardiovascular disease (CVD), and whether these effects were mediated by adiposity. Methods: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial was a multicenter double 2 by 2 factorial randomized controlled trial of 10,251 middle-aged and older people who had type 2 diabetes, a GHbA1c of 7.5% or greater, and evidence of CVD or CVD risk factors. Biomarkers were assessed in a subset of 562 participants. Intervention effects on high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were tested using linear regression models. Results: A significantly lower average hs-CRP was noted in the intensive versus the standard glycemic group (p=0.029). Adjusting for change in BMI or waist circumference resulted in larger differences in adjusted hs-CRP (p<0.001 and p<0.002, respectively) between the glycemic intervention groups. Conclusions: Intensive glycemic control was associated with a reduction in hs-CRP in this study population. Intervention associated increases in adiposity suppressed the beneficial effect of intensive glycemic control on lowering hs-CRP.

Original languageEnglish (US)
Pages (from-to)389-398
Number of pages10
JournalDiabetes Research and Clinical Practice
Volume95
Issue number3
DOIs
StatePublished - Mar 1 2012

Keywords

  • ACCORD trial
  • Adiposity
  • CVD
  • Hs-CRP
  • Inflammation
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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