Sialic acid and incidence of hospitalization for diabetes and its complications during 40-years of follow-up in a large cohort: The Värmland survey

•Inflammatory markers predict incident type-2 diabetes.•Inflammation plays a role for the development of diabetes complications.•The association between sialic acid and incident diabetes has been studied.•87,035 men and women have been followed-up in national registers.•Sialic acid is independently associated with risk of incident diabetes.

AimTo examine the association of sialic acid (SA) with first recorded diabetes mellitus-related hospitalization.MethodsFrom a population-based study in Värmland, Sweden, between 1962 and 1965, 87,035 men and women were selected and followed for first recorded diabetes-related hospitalization until 2005. The association of SA was calculated and stratified for gender by Cox's proportional hazards models. Adjustments were made for conventional risk factors and socioeconomic status. Association analyses were made for comparisons between SA-levels above and below median.ResultsThe mean age was 47.2 (SD 13.0) years and the total numbers of incident diabetes-related hospitalizations in men and women were 3445 and 3273, respectively. Hazard ratios per one standard deviation of SA were 1.12 (95% CI: 1.08–1.17, p < 0.0001) in men and 1.17 (95% CI: 1.13–1.22, p < 0.0001) in women. Interaction analyses indicated a relatively higher SA-associated risk in women than in men with above median SA levels.ConclusionsIn this large population-based cohort followed for more than 40 years, elevated SA, as a marker of systemic inflammation, was independently associated with risk of diabetes and diabetes-related hospitalizations.