Diabetes research and clinical practice · 2011
The effect of intensive risk factor management in type 2 diabetes on inflammatory biomarkers.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Samaropoulos Xanthia F, Light Laney, Ambrosius Walter T, Marcovina Santica M, Probstfield Jeffrey, Goff David C
Аннотация
AIMS: To determine whether intensive risk factor management reduced markers of inflammation in middle-aged and older people with type 2 diabetes who either had, or were at risk for cardiovascular disease (CVD), and whether these effects were mediated by adiposity.
METHODS: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial was a multicenter double 2 by 2 factorial randomized controlled trial of 10,251 middle-aged and older people who had type 2 diabetes, a GHbA1c of 7.5% or greater, and evidence of CVD or CVD risk factors. Biomarkers were assessed in a subset of 562 participants. Intervention effects on high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were tested using linear regression models.
RESULTS: A significantly lower average hs-CRP was noted in the intensive versus the standard glycemic group (p=0.029). Adjusting for change in BMI or waist circumference resulted in larger differences in adjusted hs-CRP (p<0.001 and p<0.002, respectively) between the glycemic intervention groups.
CONCLUSIONS: Intensive glycemic control was associated with a reduction in hs-CRP in this study population. Intervention associated increases in adiposity suppressed the beneficial effect of intensive glycemic control on lowering hs-CRP.
METHODS: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial was a multicenter double 2 by 2 factorial randomized controlled trial of 10,251 middle-aged and older people who had type 2 diabetes, a GHbA1c of 7.5% or greater, and evidence of CVD or CVD risk factors. Biomarkers were assessed in a subset of 562 participants. Intervention effects on high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) were tested using linear regression models.
RESULTS: A significantly lower average hs-CRP was noted in the intensive versus the standard glycemic group (p=0.029). Adjusting for change in BMI or waist circumference resulted in larger differences in adjusted hs-CRP (p<0.001 and p<0.002, respectively) between the glycemic intervention groups.
CONCLUSIONS: Intensive glycemic control was associated with a reduction in hs-CRP in this study population. Intervention associated increases in adiposity suppressed the beneficial effect of intensive glycemic control on lowering hs-CRP.