Influence of Lifestyle Factors on Inflammation in Men and Women with Type 2 Diabetes: Results from the National Health a
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ORIGINAL ARTICLE
Influence of Lifestyle Factors on Inflammation in Men and Women with Type 2 Diabetes: Results from the National Health and Nutrition Examination Survey, 1999–2004 Soghra Jarvandi, PhD & Nicholas O. Davidson, MD & Donna B. Jeffe, PhD & Mario Schootman, PhD Published online: 3 August 2012 # The Society of Behavioral Medicine 2012
Abstract Background Type 2 diabetes is associated with low-grade systemic inflammation, increasing the risk for various adverse health outcomes. Purpose Our objective was to investigate the association between C-reactive protein (CRP), a marker for systemic inflammation, and lifestyle factors in a national sample of people with type 2 diabetes. Methods This study analyzed data from 1,086 men and women with diabetes, who completed the 1999–2004 NHANES. Lifestyle factors included diet quality, body mass index (BMI), smoking, and physical activity. Results Stratified logistic regression showed that for both men and women, BMI was a strong predictor of elevated CRP after adjusting for age, energy intake, race/ethnicity, medications, diabetes duration, and glycosylated hemoglobin. However, among men, but not among women, the likelihood of elevated CRP increased with lower diet quality and physical inactivity. Conclusions Among people with type 2 diabetes, higher levels of CRP were associated with lower diet quality and physical inactivity among men, and with obesity among both men and women. S. Jarvandi (*) : D. B. Jeffe : M. Schootman Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Blvd, Box 8504, Saint Louis, MO 63108, USA e-mail: [email protected] N. O. Davidson Division of Gastroenterology, Washington University School of Medicine, Saint Louis, MO, USA N. O. Davidson : D. B. Jeffe : M. Schootman Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, Saint Louis, MO, USA
Keywords Type 2 diabetes . C-reactive protein . Lifestyle . Inflammation
Introduction Type 2 diabetes is among the most common chronic diseases in the USA, affecting about 8 % of the population [1]. People with type 2 diabetes are at increased risk for many diseases and conditions; for example, they are up to four times more likely to develop cardiovascular disease than people without diabetes [2]. Diabetes is associated with low-grade systemic inflammation [3], which is suggested to play a role in pathogenesis of cardiovascular disease, and thus may be responsible for the increased cardiovascular risk among diabetics [4]. A healthy lifestyle may reduce systemic inflammation, and thus decrease the risk of cardiovascular disease among the general population [5]. In particular, elevated C-reactive protein (CRP), a marker for systemic inflammation, has been associated with lifestyle risk factors for cardiovascular disease, such as obesity [6], physical inactivity [7], cigarette smoking [8], and high intake of saturated fat [9] and low intake of fruit and vegetables [10], and whole grains [11]. However, little i
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