The Association of Hemoglobin A1c and Fasting Glucose Levels with hs-CRP in Adults Not Diagnosed with Diabetes from the KNHANES, 2017

PURPOSE: High sensitivity C-reactive protein (hs-CRP) has been used as a biomarker to assess the risk of cardiovascular accidents (CVA) and to measure general inflammation in the body. This study investigated the relationship and extent of correlation between serum glucose level markers and hs-CRP as a means to assess CVA risk through hemoglobin A1c (HbA1c) and fasting glucose levels. METHODS: This cross-sectional, population-based study used data from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). From the total sample of 8,127 people, 4,590 subjects were excluded due to age (<19 years) (n = 1,505), diabetes mellitus (DM) diagnosis or medication (n = 596), inactivity (n = 424), pregnancy (n = 17), hypoglycemia (<70 mg/dL) (n = 8), smoking history (n = 1,077), and missing data (n = 963). In total, 3,537 adults not diagnosed with diabetes were selected. Their hs-CRP levels were compared with the glucose level markers using a complex sample general linear regression analysis. RESULTS: We adjusted for sedentary hours, smoking, binge drinking frequency, age, sex, mean SBP, triglycerides, and waist circumference. Increases in HbA1c correlated with hs-CRP levels (B coefficient (95%CI) = 0.185, p = 0.001, and R(2) = 0.087). Changes in the fasting glucose levels were also associated with the hs-CRP levels (B coefficient (95%CI) = 0.005, p = 0.006, and R(2) = 0.086). CONCLUSION: This study showed a linear association between HbA1c and fasting glucose levels and hs-CRP. It also showed that changes in the hs-CRP level were better correlated with those in the HbA1c levels than in the fasting glucose levels.