High sensitivity C‐reactive protein and prediabetes progression and regression in middle‐aged and older adults: A prospective cohort study

ABSTRACT Background This study aimed to investigate the effect of systemic inflammation, assessed by high sensitivity C‐reactive protein (hs‐CRP) levels, on prediabetes progression and regression in middle‐aged and older adults based on the China Health and Retirement Longitudinal Study (CHARLS). Methods Participants with prediabetes from CHARLS were followed up 4 years later with blood samples collected for measuring fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). The level of hs‐CRP was assessed at baseline and categorized into tertiles (low, middle, and high groups). Prediabetes at baseline and follow‐up was defined primarily according to the American Diabetes Association (ADA) criteria. Logistic regression models were used to estimate the odds ratios (ORs) and confidence intervals (CIs). We also performed stratified analyses according to age, gender, BMI, the presence of hypertension, and the disease history of heart disease and dyslipidemia and sensitivity analyses excluding a subset of participants with incomplete data. Results Of the 2,874 prediabetes included at baseline, 834 participants remained as having prediabetes, 146 progressed to diabetes, and 1,894 regressed to normoglycemia based on ADA criteria with a 4 year follow‐up. After multivariate logistics regression analysis, prediabetes with middle (0.67–1.62 mg/L) and high (>1.62 mg/L) hs‐CRP levels had an increased incidence of progressing to diabetes compared with prediabetes with low hs‐CRP levels (