High-grade inflammation, metabolic abnormalities, and incident type 2 diabetes: a dynamic matched prospective cohort study
9 affiliations
- 1Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College
- 2Nutrition and Health Innovation Research Institute, Edith Cowan University School of Medical and Health Sciences
- 3Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University
- 4Cardiovascular Medicine Division, University of Pennsylvania Perelman School of Medicine
- 5Xiangya School of Nursing, Central South University
- 6Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University
- 7Department of Cardiology, The First Affiliated Hospital of Dalian Medical University
- 8Glycomedicine Research Institute, Shantou University Medical College
- 9Department of Cardiology, Kailuan General Hospital
Abstract
Aims: To investigate the association between high-grade inflammation and incident type 2 diabetes (T2D) and assess how this risk varied according to metabolic abnormalities and risk factor control.
Methods: Within the Kailuan cohort, 9,347 individuals with high-grade inflammation (hsCRP ≥10 mg/L) between 2006/2007 and 2016/2017 were dynamically matched by age and sex at a prespecified 1:4 ratio to 31,584 non-inflamed participants. Multivariable Cox regression models adjusted for demographic, lifestyle, renal, lipid, blood pressure, and adiposity-related factors were used to estimate hazard ratios (HRs) for incident T2D overall, across metabolic and risk factor strata.
Results: Participants with high-grade inflammation had greater adiposity and more adverse metabolic profiles than matched non-inflamed participants. During a median 10.1 years of follow-up, T2D developed in 17.7% of participants with high-grade inflammation and 13.1% of matched non-inflamed participants. High-grade inflammation was associated with a 24% higher adjusted risk of T2D (HR 1.24, 95% CI 1.16–1.33). Diabetes risks were further elevated when high-grade inflammation coexisted with metabolic abnormalities, ranging from 2.25 for overweight/obesity to 4.24 for impaired fasting glucose. Management of BMI, waist-to-height ratio, or blood pressure largely attenuated the excess risk, whereas favorable smoking or renal function control alone was insufficient.
Conclusions: High-grade inflammation was associated with a higher risk of T2D, particularly in the presence of metabolic abnormalities. Maintaining a healthy weight and optimal blood pressure may help attenuate this risk, highlighting the potential importance of integrating high-grade inflammation and metabolic status in diabetes risk assessment and prevention.
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BibTeX
@article{lan2026highgrade,
title = {{High-grade inflammation, metabolic abnormalities, and incident type 2 diabetes: a dynamic matched prospective cohort study}},
author = {Yulong Lan and Dan Wu and Xiong Ding and Lingyu Xu and Hui Zhou and Mengyi Zheng and Zegui Huang and Peng Fu and Zekai Chen and Wei Wang and Shouling Wu and Youren Chen},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1968030},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1968030/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - High-grade inflammation, metabolic abnormalities, and incident type 2 diabetes: a dynamic matched prospective cohort study
AU - Yulong Lan
AU - Dan Wu
AU - Xiong Ding
AU - Lingyu Xu
AU - Hui Zhou
AU - Mengyi Zheng
AU - Zegui Huang
AU - Peng Fu
AU - Zekai Chen
AU - Wei Wang
AU - Shouling Wu
AU - Youren Chen
PY - 2026
DA - 2026/10/16
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1968030
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1968030/full
AB - Aims: To investigate the association between high-grade inflammation and incident type 2 diabetes (T2D) and assess how this risk varied according to metabolic abnormalities and risk factor control. Methods: Within the Kailuan cohort, 9,347 individuals with high-grade inflammation (hsCRP ≥10 mg/L) between 2006/2007 and 2016/2017 were dynamically matched by age and sex at a prespecified 1:4 ratio to 31,584 non-inflamed participants. Multivariable Cox regression models adjusted for demographic, lifestyle, renal, lipid, blood pressure, and adiposity-related factors were used to estimate hazard ratios (HRs) for incident T2D overall, across metabolic and risk factor strata. Results: Participants with high-grade inflammation had greater adiposity and more adverse metabolic profiles than matched non-inflamed participants. During a median 10.1 years of follow-up, T2D developed in 17.7% of participants with high-grade inflammation and 13.1% of matched non-inflamed participants. High-grade inflammation was associated with a 24% higher adjusted risk of T2D (HR 1.24, 95% CI 1.16–1.33). Diabetes risks were further elevated when high-grade inflammation coexisted with metabolic abnormalities, ranging from 2.25 for overweight/obesity to 4.24 for impaired fasting glucose. Management of BMI, waist-to-height ratio, or blood pressure largely attenuated the excess risk, whereas favorable smoking or renal function control alone was insufficient. Conclusions: High-grade inflammation was associated with a higher risk of T2D, particularly in the presence of metabolic abnormalities. Maintaining a healthy weight and optimal blood pressure may help attenuate this risk, highlighting the potential importance of integrating high-grade inflammation and metabolic status in diabetes risk assessment and prevention.
SN - 1664-2392
ER -