High-grade inflammation, metabolic abnormalities, and incident type 2 diabetes: a dynamic matched prospective cohort study.

Authors

Yulong Lan, Dan Wu, Xiong Ding, Lingyu Xu, Hui Zhou, Mengyi Zheng, Zegui Huang, Peng Fu, Zekai Chen, Wei Wang, Shouling Wu, Youren Chen

Published in

Frontiers in endocrinology. Volume 17. Pages 1968030. Epub Oct 16, 2026.

Abstract

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.
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.
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.
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.

PMID:
42964057
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.

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