A 1-year lifestyle intervention for weight loss in individuals with type 2 diabetes reduces high C-reactive protein levels and identifies metabolic predictors of change: from the Look AHEAD (Action for Health in Diabetes) study.

Description

The objective of this study was to investigate the impact of a 1-year lifestyle intervention for weight loss on levels of high-sensitivity C-reactive protein (hs-CRP) in type 2 diabetic patients. The study cohort included 1,759 subjects from the Look AHEAD study, a multicentre clinical trial where subjects were randomly assigned to a lifestyle intervention (ILI) or to usual care (diabetes support and education [DSE]). Results showed that 1 year of lifestyle intervention was accompanied by an 8.8% reduction in baseline weight, a 0.7% drop in HbA1c as well as a 43.6% decrease in median hs-CRP compared to a 16.7% reduction with DSE. ILI also increased fitness (19%) and HDL cholesterol (7.5%) compared with changes observed with DSE. Among the various metabolic variables, changes in adiposity and glucose control with ILI were the only independent predictors of hs-CRP reduction after adjusting for multiple covariates such as traditional risk factors, pharmacotherapy and changes in fitness. Thus, these results suggest that a 1-year lifestyle intervention can significantly lower hs-CRP levels in obese individuals with type 2 diabetes and that changes in adiposity and glucose control contribute to this reduction in hs-CRP.