Journal
DIABETES CARE
Volume 42, Issue 11, Pages 2083-2089Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc18-2563
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Funding
- National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH) [U54MD008149]
- NIH [UL1TR000124, P30AG021684]
- Ramalingaswami Fellowship from the Department of Biotechnology, Government of India
- Jackson State University from the National Heart, Lung, and Blood Institute [HHSN268201800013I]
- Tougaloo College from the National Heart, Lung, and Blood Institute [HHSN268201800014I]
- Mississippi State Department of Health from the National Heart, Lung, and Blood Institute [HHSN268201800015I/HHSN26800001]
- University of Mississippi Medical Center from the National Heart, Lung, and Blood Institute [HHSN268201800010I, HHSN268201800011I, HHSN268201800012I]
- University of Mississippi Medical Center from the National Institute on Minority Health and Health Disparities [HHSN268201800010I, HHSN268201800011I, HHSN268201800012I]
- Jackson State University from the National Institute on Minority Health and Health Disparities [HHSN268201800013I]
- Tougaloo College from the National Institute on Minority Health and Health Disparities [HHSN268201800014I]
- Mississippi State Department of Health from the National Institute on Minority Health and Health Disparities [HHSN268201800015I/HHSN26800001]
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OBJECTIVE African Americans (AA) suffer disproportionately from diabetic nephropathy (DN). C-reactive protein (CRP) has been associated with prevalent DN, but its association with incident DN in AA is unknown. We examined hs-CRP and incident DN in AA. RESEARCH DESIGN AND METHODS We conducted a longitudinal analysis of data from exams 1, 2, and 3 in 4,043 eligible Jackson Heart Study (JHS) participants. Participants with DN or without hs-CRP at exam 1 were excluded. Incident DN was defined as urinary albumin-to-creatinine ratio (ACR) >30 mg/g or self-reported dialysis/transplantation and type 2 diabetes mellitus (DM) or HbA(1c) >6.5% by exam 2 or 3 among participants free of DN at exam 1. Kaplan-Meier curves examined DN event-free survival probability by hs-CRP. With Cox proportional hazards regression we estimated hazard ratios (HRs) and 95% CI for DN by hs-CRP tertiles, adjusting for demographics and clinical and laboratory data. RESULTS During 7.8 years of median follow-up time, participants who developed DN had significantly higher baseline hs-CRP, age, fasting glucose, triglycerides, ACR, systolic blood pressure, waist circumference, and duration of DM (P < 0.05). The overall incident rate of DN was 7.9%. The mean time to incident DN was shorter for participants with hs-CRP in the high tertile (>4.24 mg/L) than in the low tertile (<1.46 mg/L); P < 0.001. Participants with high hs-CRP had higher incidence of DN (HR 2.34, 95% CI 1.04-5.24) versus the reference group. CONCLUSIONS Inflammation, as measured by hs-CRP levels, may be associated with incident DN in AA. Further studies are warranted to replicate and elucidate the basis for this association.
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