Association between Inflammatory Markers and Glycemic Control in Korean Diabetic Patients

Abstract

Objectives: This study evaluated the association between inflammatory markers and glycemic control in Korean patients with diabetes mellitus.Methods: Using data from the 2007-2018 Korean National Health and Nutritional Examination, 4,186 diabetic subjects aged between 19 and 80 years were included in this study. Poor glycemic control was defined as level of HbA1c higher than 7%. Inflammation was measured by inflammatory markers including white blood cell (WBC) count and high-sensitivity C-reactive protein (hsCRP), and those inflammatory markers were categorized into 4 groups by quartiles. A multiple logistic regression analysis was performed to evaluate the association between quartile of inflammatory markers and poor glycemic control after adjusting for demographic factors, lifestyle, and comorbidities.Results: Levels of WBC count and hsCRP were positively associated with the risk of poor glycemic control even after fully adjusting for potential confounders. For WBC count, compared with the first quartile, the second quartile was 1.50 (95% confidence interval, CI: 1.26-1.78), 1.71 (95 % CI:1.43-2.05) for the third, 2.00 (95% CI: 1.67-2.40) for the fourth. In case of hsCRP, compared with the first quartile, the second quartile was 1.15 (95% CI: 0.87-1.53), 1.59 (95% CI: 1.20-2.11) for the third, and 1.59 (95% CI: 1.19-2.12) for the fourth. There was significant age difference in the association between hsCRP and glycemic control. The association was more evident in the younger group than in the elderly group. Conclusions: High level of WBC and hsCRP were positively associated with the risk of poor glycemic control. These results suggest that in a Korean diabetic patient, inflammation was significantly associated with poor glycemic control.