TY - JOUR
T1 - The effect of intensive risk factor management in type 2 diabetes on inflammatory biomarkers
AU - Samaropoulos, Xanthia F.
AU - Light, Laney
AU - Ambrosius, Walter T.
AU - Marcovina, Santica M.
AU - Probstfield, Jeffrey
AU - Goff, David C.
N1 - Funding Information:
This work is supported by US National Institutes of Health; National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Diseases; National Institute on Aging; National Eye Institute; Centers for Disease Control and Prevention; General Clinical Research Centers; and the American Diabetes Association.
Funding Information:
ACCORD-MIND-MRI Biomarker Substudy funded by the American Diabetes Association: Grant No: 1-07-Accord-01.
PY - 2012/3
Y1 - 2012/3
N2 - 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.
AB - 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.
KW - ACCORD trial
KW - Adiposity
KW - CVD
KW - Hs-CRP
KW - Inflammation
KW - Type 2 diabetes
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U2 - 10.1016/j.diabres.2011.09.027
DO - 10.1016/j.diabres.2011.09.027
M3 - Article
C2 - 22019270
AN - SCOPUS:84857238882
SN - 0168-8227
VL - 95
SP - 389
EP - 398
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 3
ER -