Inflammatory Level As An Indicator To Identify Whether Obesity Leads To Increased Risk Of Type 2 Diabetes

Background:Diabetes is one of the most important noncommunicable diseases that currently threaten human health worldwide.Along with the social development,rapid industrialization and urbanization has changed the way people dietary structure and life behavior,overweight and obesity rise rapidly in the past three decades and become the important public health problem.Obesity can lead to a series of poor health outcomes,which are independent risk factors for type 2 diabetes,increase the risk of deeloping type 2 diabetes.However,recent research shows that not all obese people are at an elevated risk of T2D.Therefore,it is particularly urgent to define the pathogenesis of type 2 diabetes in obesity.Previous studies have shown that chronic inflammation levels in obese people are higher than those of normal people.In addition,inflammation is an important contributor to T2D via the processes of insulin resistance and islet?-cell failure.Therefore inflammation may be one of the important mechanisms of T2D as a result of obesity.At the same time,there are obesity people with low levels of inflammation,and these particular groups are getting more and more attention.However,there is no relevant study on the relationship between inflammatory levels and the T2D risk of obesity.the role of inflammatory levels in predicting whether obesity is associated with an increased risk of type 2 diabetes.Therefore,we hypothesize that inflammation can be used as an indicator to identify whether or not obesity leads to increased risk of T2D.To investigate this hypothesis,we conducted a prospective cohort study in a general population.Objective:This study is based on cohort studies from large sample populations from physical examination.Objective to comprehensively identify the relationship between inflammatory levels and the T2D risk of obesity.Methods:The population of this study was from the low-grade inflammation and health promotion cohort in tianjin.Through a series of inclusion exclusion criteria,a total of 47,678 initially subjects were followed up from 2007 to 2016.All subjects volunteered to participate in the study and signed a informed consent form.The subjects were interviewed by questionnaire,physical examination and blood biochemical analysis.All inspections are measured by standard measurement methods.White blood cell count was measured as a surrogate marker of systemic inflammation.The diagnostic criteria for obesity were adopted by the world health organization(who)Asian population diagnostic criteria:24kg/m~2 is less than or equal to a BMI of27.9kg/m~2 is defined as being overweight;BMI greater than 28kg/m~2 is defined as obesity.T2D diagnostic criteria use the latest T2D diagnostic criteria developed by the Chinese medical association diabetes association in 2013.SAS9.3 statistical software was used for statistical analysis.For continuous variables and categorical variables,variance analysis and Logistic regression analysis were used respectively to compare the characteristics of T2D and non-t2d population.According to whether obesity and whether high inflammation is divided into four groups as the independent variable,whether T2D as dependent variable,using analysis of variance and COX proportional hazards regression model to assess relationships between obese status,inflammation levels and the incidence of T2D.Results:During the approximately~9-year follow-up period(median duration of follow-up:3.48y),1,463 subjects developed T2D.There were statistically significant differences in age,gender,WC,BMI,TC,TG,hdl-c,SBP,DBP,FBG,MetS prevalence and Family disease history distribution between T2D and non-t2d population in baseline(P<0.05).In the final multivariate model,the age,gender,state of baseline BMI,waist circumference,smoking status,alcohol,baseline fasting glucose,metabolic syndrome and cardiovascular disease,hypertension,hyperlipidemia,diabetes family history,after adjusting for factors to obesity inflammation group as control group,the hazard ratios(95%confidence interval)of T2D for obese participants with elevated levels of inflammation,non-obese participants with elevated levels of inflammation,and non-obese participants with decreased levels of inflammation,when compared to obese participants with decreased levels of inflammation were:1.22(1.03–1.44),1.37(1.12–1.66)and0.99(0.83–1.20),respectively.Different genders were analyzed and similar results were obtained in the male group,while no statistical difference was found in the female group.Conclusions:The results showed that compared with the obese and low inflammatory population,there was a higher risk of T2D in the obese and high level inflammatory people,and the difference was statistically significant.However,there was no significant difference in T2D risk among obese and low inflammatory groups compared with non-obese and low inflammatory population.This conclusion suggests that inflammation is a factor contributing to the increased risk of T2D.In addition,after the final adjustment of confounding factors,compared with the obese and low inflammatory population,the non-obese and high inflammatory population also had a higher risk of T2D,and the difference was statistically significant.There was no statistically significant difference in T2D risk between obese and low inflammatory population and low inflammatory population.The above results suggest that inflammatory levels can be used as predictors of whether obesity increases T2D risk.The same conclusion applies to men after gender groups.Therefore,this study demonstrated that levels of inflammatory can be used as an indicator to identify whether or not obesity leads to increased risk of T2D.