Synergistic effects of overweight/obesity and high hemoglobin A1c status on elevated high-sensitivity C-reactive protein in Chinese adults: a cross-sectional study

Qianqian Shen; Tingchao He; Ting Li; Ignatius Man-Yau Szeto; Shuai Mao; Wuxian Zhong; Pin Li; Hua Jiang; Yumei Zhang

doi:10.3389/fnut.2023.1156404

Synergistic effects of overweight/obesity and high hemoglobin A1c status on elevated high-sensitivity C-reactive protein in Chinese adults: a cross-sectional study

Front Nutr. 2023 May 5:10:1156404. doi: 10.3389/fnut.2023.1156404. eCollection 2023.

Authors

Qianqian Shen¹, Tingchao He^{2

3}, Ting Li^{2

3}, Ignatius Man-Yau Szeto^{2

4}, Shuai Mao¹, Wuxian Zhong¹, Pin Li¹, Hua Jiang⁵, Yumei Zhang¹

Affiliations

¹ Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China.
² Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot, China.
³ Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China.
⁴ National Center of Technology Innovation for Dairy, Hohhot, China.
⁵ School of Nursing, Peking University, Beijing, China.

Abstract

Background: High-sensitivity C-reactive protein (hs-CRP) is an inflammatory marker that has been suggested as a predictor of cardiovascular diseases. High glycated hemoglobin (HbA1c) levels and overweight/obesity are independently associated with elevated hs-CRP; meanwhile, high HbA1c levels are frequently accompanied by overweight or obesity. However, their joint effect on elevated hs-CRP levels has not been well-established. Therefore, we evaluated whether overweight/obesity modified the association between high HbA1c levels and elevated hs-CRP.

Methods: Based on cross-sectional data from the Chinese Urban Adults Diet and Health Study (CUADHS) in 2016, we included 1,630 adults aged 18-75 years (mean age 50.16 years and 33.6% male). Elevated hs-CRP was defined as serum hs-CRP ≥ 3 and <10 mg/L. The interactive effects of BMI and HbA1c levels on the risk of elevated hs-CRP levels were calculated by using multiple logistic regression models, followed by strata-specific analyses.

Results: Individuals with elevated hs-CRP had a higher rate of HbA1c level than those without elevated (25.3 vs. 11.3%, P < 0.001), as well as a higher rate of overweight/obesity (67.1 vs. 43.5%, P < 0.001). Higher HbA1c levels were independently associated with an increased risk of elevated hs-CRP [adjusted odds ratio (aOR) = 2.31, 95% confidence interval (CI): 1.47, 3.65], as well as overweight/obesity with the risk of elevated hs-CRP (aOR = .31, 95% confidenc-3.73). Furthermore, overweight/obesity showed a significant synergistic effect on high HbA1c levels with a higher aOR of 5.25 (2.77, 9.95) (P_interaction < 0.001). This synergistic effect was more prominent when stratified by age (in 18-44 years old, aOR, 95% CI = 30.90, 4.40-236.47 for interaction vs. 6.46, 1.38-30.23 for high HbA1c only) and gender (in women, aOR, 95% CI = 8.33, 3.80-18.23 for interaction vs. 2.46,1.38-4.40 for high HbA1c only).

Conclusion: There are synergistic effects of high HbA1c levels and overweight/obesity on the risk of elevated hs-CRP in Chinese adults, with more significant effects in adults aged 18-44 years or females. Intervention strategies for preventing high blood glucose levels and body weight simultaneously may be important for reducing hs-CRP-related diseases. Further studies are needed to confirm this finding in other populations, and its molecular mechanisms need to be elucidated.

Keywords: BMI; Chinese adults; HbA1c; hs-CRP; interaction.

Grants and funding

This research was funded by National Center of Technology Innovation for Dairy and Inner Mongolia Dairy Technology Research Institute (Hohhot Science & Technology Plan, 2020-Ke Ji Xing Meng-Project No. 4). The authors declare that this study received funding from Inner Mongolia Dairy Technology Research Institute. The funder had the following involvement in the study: TH, TL, and IS.