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Association of Serum C-Reactive Protein Level with Sex-Specific Type 2 Diabetes Risk: A Prospective Finnish Study

Departments of Health Promotion and Chronic Diseases Prevention (G.H., P.J., J.T., V.S.) and Health and Functional Capacity (J.S.), National Public Health Institute, FIN-00300, Helsinki, Finland; Department of Public Health (G.H., J.T.), University of Helsinki, FIN-00014, Helsinki, Finland; Chronic Disease Epidemiology Laboratory (G.H.), Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana 70808; South Ostrobothnia Central Hospital (J.T.), 60220, Seinäjoki, Finland; Oulu City Hospital (R.A.), 90015 Oulu, Finland; and Imperial College, Division of Medicine, Hammersmith Campus (R.A.), London W12 ONN, United Kingdom

Address all correspondence and requests for reprints to: Gang Hu, M.D., Ph.D., Chronic Disease Epidemiology Laboratory, Population Science, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808. E-mail: gang.hu{at}pbrc.edu.

Objective: Our objective was to assess whether the association of serum C-reactive protein (CRP) with type 2 diabetes risk is modified by sex.

Design and Subjects: We prospectively followed 12,861 Finnish men and women who were 35–74 yr of age, and free of diabetes, coronary heart disease, stroke, and cancer at baseline. Hazard ratios of type 2 diabetes were estimated for different levels of serum CRP.

Results: During the follow-up, 208 men and 113 women developed diabetes. The multivariable-adjusted (age, physical activity, education, smoking, alcohol and coffee drinking, family history of diabetes, use of antihypertensive drugs, cholesterol-lowering agents, and hormone replacement therapy in women, systolic blood pressure, serum high-density lipoprotein cholesterol, serum triglycerides, and body mass index) hazard ratios of diabetes at three different levels of CRP (0.05–0.99, 1.0–2.99, and 3.0 mg/liter) based on the recommendation by Centers for Disease Control and the American Heart Association were 1.00, 1.46, and 1.85 (P for trend = 0.006) in men, and 1.00, 3.83, and 8.37 (P for trend <0.001) in women, respectively. CRP had a stronger association with diabetes risk in women than men (P for interaction: ² = 6.42; 1 df; P < 0.025). This positive association between CRP and diabetes risk did not change when participants were stratified by age group, smoking status, level of obesity, alcohol drinking habit, or family history of diabetes.

Conclusions: High baseline level of serum CRP was associated with an increased risk of diabetes among both men and women, but this association was stronger in women than men.