Chronic Inflammation Plays a Role of a Bridge Between Cardiovascular Disease and Hyperglycemia

Metab Syndr Relat Disord. 2023 Oct;21(8):468-474. doi: 10.1089/met.2023.0086. Epub 2023 Oct 5.

Abstract

Background: Chronic inflammation is believed to play a key role in managing cardiovascular disease (CVD) and glycometabolism, but the specific effects remain unclear. The subclinical features of CVD events and hyperglycemia linked to inflammatory status were evaluated in this study. In addition, independent factors associated with inflammatory status were identified. Methods: Inflammatory status was measured by high-sensitivity C-reactive protein (hs-CRP), CVD events estimated by carotid intima-media thickness (cIMT), and hyperglycemia determined by glycated hemoglobin (HbA1c). Univariate analysis was performed to identify the characteristics of HbA1c-defined normoglycemia, prediabetes, and diabetes, whereas multivariate linear regression analysis was conducted to identify independent factors that correlated with hs-CRP levels. Results: Compared with HbA1c-defined normoglycemia, individuals with prediabetes and diabetes had significantly higher risks of cIMT thickening [risk ratio (RR) was 2.21 and 2.40, respectively], carotid atherosclerosis (RR was 2.29 and 3.04, respectively), and carotid plaque (RR was 2.15 and 2.63, respectively). Diabetes had higher risks of carotid atherosclerosis (RR was 1.33) and carotid plaque (RR was 1.22) than prediabetes. Increasing prevalence of cIMT thickening, atherosclerosis, and plaque was correlated with hs-CRP levels rising. There was a notable linear relationship between HbA1c and hs-CRP levels (R2 = 0.8685). In addition, both men and women showed an independent correlation of hs-CRP levels with HbA1c and low-density lipoprotein cholesterol, whereas men also had thyroid-stimulating hormone and women had age as an independent factor. Conclusions: Chronic inflammation links hyperglycemia to CVD events, and the relevant risk factors would be potential targets for alleviating inflammation and delaying the progression of the atherogenic process.

Keywords: atherosclerosis cardiovascular disease; carotid intima-media thickness; chronic inflammation; diabetes; glycated hemoglobin; prediabetes.

MeSH terms

  • Atherosclerosis*
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases* / epidemiology
  • Carotid Artery Diseases* / complications
  • Carotid Artery Diseases* / diagnostic imaging
  • Carotid Artery Diseases* / epidemiology
  • Carotid Intima-Media Thickness
  • Female
  • Glycated Hemoglobin
  • Humans
  • Hyperglycemia* / complications
  • Hyperglycemia* / epidemiology
  • Inflammation
  • Male
  • Prediabetic State* / complications
  • Prediabetic State* / epidemiology
  • Risk Factors

Substances

  • C-Reactive Protein
  • Glycated Hemoglobin