Profile of the Immune and Inflammatory Response in Individuals With Prediabetes and Type 2 Diabetes

被引：206

作者：

Grossmann, Vera ^{[1
]}

Schmitt, Volker H. ^{[2
]}

Zeller, Tanja ^{[3
,4
]}

Panova-Noeva, Marina ^{[1
]}

Schulz, Andreas ^{[5
]}

Laubert-Reh, Dagmar ^{[5
]}

Juenger, Claus ^{[5
]}

Schnabel, Renate B. ^{[3
,4
]}

Abt, Tobias G. J. ^{[2
]}

Laskowski, Rafael ^{[2
]}

Wiltink, Joerg ^{[6
]}

Schulz, Eberhard ^{[2
]}

Blankenberg, Stefan ^{[3
,4
]}

Lackner, Karl J. ^{[7
]}

Muenzel, Thomas ^{[2
,8
]}

Wild, Philipp S. ^{[1
,5
,8
]}

机构：

[1] Univ Med Ctr Mainz, Ctr Thrombosis & Hemostasis, Mainz, Germany

[2] Univ Med Ctr Mainz, Dept Med 2, Mainz, Germany

[3] Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany

[4] German Ctr Cardiovasc Res DZHK, Kiel, Germany

[5] Univ Med Ctr Mainz, Dept Med 2, Prevent Cardiol & Prevent Med, Mainz, Germany

[6] Univ Med Ctr Mainz, Dept Psychosomat Med & Psychotherapy, Mainz, Germany

[7] Univ Med Ctr Mainz, Inst Clin Chem & Lab Med, Mainz, Germany

[8] German Ctr Cardiovasc Res DZHK, Mainz, Germany

来源：

DIABETES CARE | 2015年 / 38卷 / 07期

关键词：

C-REACTIVE PROTEIN; ACUTE-PHASE REACTANTS; BLOOD-CELL COUNT; CARDIOVASCULAR-DISEASE; MONICA/KORA AUGSBURG; ELEVATED LEVELS; RISK; CYTOKINES; ASSOCIATION; MELLITUS;

D O I：

10.2337/dc14-3008

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVEThe inflammatory and immune systems are altered in type 2 diabetes. Here, the aim was to profile the immune and inflammatory response in subjects with prediabetes and diabetes in a large population-representative sample.RESEARCH DESIGN AND METHODSIn total, 15,010 individuals were analyzed from the population-based Gutenberg Health Study. Glucose status was classified according to HbA(1c) concentration and history of diagnosis. All samples were analyzed for white blood cells (WBCs), granulocytes, lymphocytes, monocytes, platelets, C-reactive protein (CRP), albumin, fibrinogen, and hematocrit. Interleukin-18 (IL-18), IL-1 receptor antagonist (IL-1RA), and neopterin concentrations were determined in a subcohort.RESULTSIn total, 7,584 men and 7,426 women were analyzed (range 35-74 years), with 1,425 and 1,299 having prediabetes and diabetes, respectively. Biomarkers showed varying dynamics from normoglycemic via subjects with prediabetes to subjects with diabetes: 1) gradual increase (WBCs, granulocytes, monocytes, IL-1RA, IL-18, and fibrinogen), 2) increase with subclinical disease only (lymphocytes and CRP), 3) increase from prediabetes to diabetes only (neopterin), and 4) no variation with glucose status (hematocrit). The strongest relative differences were found for CRP, IL-1RA, and fibrinogen concentrations. Several inflammatory and immune markers were associated with the glucose status independent from cardiovascular risk factors and comorbidities, varied with disease severity and the presence of disease-specific complications in the diabetes subcohort.CONCLUSIONSThe inflammatory and immune biomarker profile varies with the development and progression of type 2 diabetes. Markers of inflammation and immunity enable differentiation between the early preclinical and clinical phases of the disease, disease complications, and progression.

引用

页码：1356 / 1364

页数：9

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