Inflammatory factors and diabetes risk in health disparities populations

National Institute On Minority Health And Health Disparities

Investigators

Linked publications, trials & patents

Abstract

The mission of our research is to discern the complex relationship between social determinants of health and inflammation in explaining health disparities in chronic disease occurrence. We are using population data to understand (1) how inflammation may explain the association between social determinants of health and disease, and (2) how social determinants of health modify the relationship between inflammation and disease. Project 1. The role of inflammation on type-2 diabetes mellitus occurrence: findings from a US national study. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study, which followed a cohort of adults in 5 year-waves from 1985-2010, we examined the prospective effects of inflammation correlates on type-2 diabetes occurrence. Four inflammatory correlates, 6 measures of metabolic risk, demographics, alcohol and tobacco use were measured in Wave 7. New cases of type-2 diabetes identified at Wave 8 were used to assess overall and race-specific associations. Our findings showed that inflammatory correlates at Wave 7 predicted occurrence of type-2 diabetes at Wave 8 independent of demographics, alcohol and tobacco use, and metabolic risk factors. Race-based differences were observed in that two inflammatory correlates predicted the occurrence of type-2 diabetes only among African Americans but not among Whites. Collectively, this data reveals that inflammatory correlates are associated with development of diabetes independent of metabolic risk factors, and that the effect of inflammatory correlates on the development of type-2 diabetes may be more prominent among African Americans than whites. Additional ongoing investigations are underway to assess the role of inflammation as a mediator on the causal pathway between dysregulated abdominal visceral adipose tissue and insulin resistance in patients at risk for developing prediabetes and type-2 diabetes. Project 2. Quantifying systemic inflammation and its association with visceral obesity in US adults. Expending adiposity has been linked to chronic inflammation, which plays a central role in the progression of metabolic diseases such as diabetes. Using a novel systemic inflammation index compiled from clinical laboratory test, we are examining the association between systemic inflammation and sagittal abdominal diameter, an anthropologic measure of visceral obesity. We examined multiple waves of National Health and Nutrition Examination Survey (NHANES) data, with respondents providing biological and survey data. Demographics, self-reported diabetic status and medication use, blood glucose levels, and 6 measures of metabolic risk factors for diabetes mellitus were measured. Overall, we found that the mean systemic inflammation index was greater in persons classified as prediabetic than non-diabetic and greater in those with diabetes compared to prediabetics. Mean systemic inflammation index also varied significantly across sex and race/ethnicity. Collectively, these findings suggest that controlling systemic inflammation can reduce the risk of developing diabetes. Project 3. Differences in Quality Monitoring Practices Among Adult Diabetics in the United States Despite recent expansions in access to care, health disparities in chronic disease persists in the United States. A possible mechanism for this persistence is the disparity in access to quality care across populations. We are using pooled data from multiple cohorts of the National Health and Nutrition Examination Survey in weighted, linear regression analyses to assess differences in quality of care among adult with diabetes. Estimates are adjusted for glycemic control and social determinants of health to assess physician-monitoring and self-monitoring practices and control of diabetes.