{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:42:48Z","timestamp":1772160168734,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","award":["B2025348"],"award-info":[{"award-number":["B2025348"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","award":["B2025601"],"award-info":[{"award-number":["B2025601"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018568","name":"Special Fund Project for Science and Technology Innovation Strategy of Guangdong Province","doi-asserted-by":"publisher","award":["STKJ2023003"],"award-info":[{"award-number":["STKJ2023003"]}],"id":[{"id":"10.13039\/501100018568","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Mounting evidence has suggested the probable involvement of infections in obesity\u2010associated type 2 diabetes. This study aims to evaluate the association between acute inflammation and type 2 diabetes risk and to examine whether this association is modified by adiposity status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This study analysed 82\u2009314 participants without pre\u2010existing diabetes from a real\u2010life, prospective cohort in China. Acute immune response was defined as high\u2010sensitivity C\u2010reactive protein (hsCRP) \u226510\u2009mg\/L, and overweight\/obesity as body mass index (BMI) \u226524\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Multivariable Cox regression models estimated diabetes risk, and both multiplicative and additive interactions were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow\u2010up of 11\u2009years, 14\u2009189 participants developed diabetes. Both elevated hsCRP and overweight\/obesity independently increased diabetes risk. Acute inflammation was associated with a higher diabetes risk [hazard ratio (HR): 1.14; 95% confidence interval (CI): 1.04\u20131.22], particularly among those with excess adiposity [HR: 1.24 (1.13\u20131.36)] compared to those with normal weight [HR: 1.00 (0.83\u20131.21);\n                      <jats:italic>P<\/jats:italic>\n                      \u2010interaction\u2009=\u20090.0112]. A supra\u2010additive interaction was observed (relative excess risk due to interaction: 0.27; 95% CI: 0.02\u20130.52), with stronger synergistic effects seen in individuals under 60 and differences noted by sex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute inflammation significantly elevates diabetes risk in overweight\/obese individuals but not in those with normal weight, highlighting the synergistic role of adiposity and immune activation in diabetes pathogenesis and the importance of weight control in prevention strategies.<\/jats:p>\n                  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