The Relationship Between Diabetic And Inflammatory Markers In Firefighters

Firefighters are at risk for metabolic diseases such as Type 2 diabetes due to occupational-related stress and resulting health behaviors such as lack of sleep and poor dietary patterns. Firefighters often experience chronic inflammatory responses that may contribute to insulin resistance development. PURPOSE: This study aimed to determine the correlation between insulin resistance and inflammatory markers in firefighters. METHODS: 20 male full-time firefighters participated in this cross-sectional, correlational study. After fasting for at least 8 hours, participants had their blood drawn for subsequent analysis of circulating C-reactive protein (CRP), homocysteine, hemoglobin A1c (HbA1c), glucose, and insulin. The fasting glucose and insulin were used to estimate HOMA-IR. Separate Pearson partial correlation analyses were used to determine the relationships between markers of systemic inflammation (C-reactive protein and homocysteine) and indicators of insulin resistance [HOMA-IR and HbA1c] while controlling for body fat percentage (BF%) and Age (in years). SPSS version 29 was used for all analyses (α = 0.05). Data transformation was used where appropriate to ensure normal distribution of each variable. RESULTS: There was a significant direct relationship between homocysteine and HbA1c before (strong) and after (moderate) controlling for Age and BF% (p = 0.004, r = 0.649; p = 0.027, r = 0.552). The relationship between homocysteine and HOMA-IR was weak and non-significant and remained so after controlling for Age and BF% (p = 0.898, r = -0.032; p = 0.413, r = -0.220). The relationships between CRP and the variables HOMA-IR and HbA1c were weak and non-significant (p = 0.585, r = -0.138; p = 0.503, r = -0.169), and remained so after controlling for Age and BF% (p = 0.432, r = -0.211; p = 0.249, r = -0.306). CONCLUSIONS: Homocysteine and HbA1c were directly related among this sample of firefighters. Future large-scale studies are needed to establish the contribution of inflammatory markers to insulin resistance. Finding effective and feasible interventions to enhance this population's metabolic and cardiovascular health will require more investigation.