Study exploring link between inflammation and diabetes

WASHINGTON -- What if you could be fat but avoid heart disease or diabetes? Scientists trying to break the fat-and-disease link increasingly say inflammation is the key. In the quest to prove it, a major study is under way testing whether an anti-inflammatory drug -- an old, cheap cousin of aspirin -- can fight the type II diabetes spurred by obesity.

And new research illustrates how those yellow globs of fat lurking under the skin are more than a storage site for extra calories. They're a toxic neighborhood where inflammation appears to be born.

Diabetes and heart disease usually tag along with extra pounds, a huge risk for the two-thirds of Americans who are overweight or obese. What isn't clear is what sets off the cascade of damage that ends in those illnesses.

"It's something we don't understand, why some people are more susceptible and others are not so susceptible," said Dr. Carey Lumeng of the University of Michigan.

Solving that mystery could point to more targeted treatments for obesity's threats. The chief suspect: Inflammation that the immune system normally uses to fight infection runs amok with weight gain -- simmering inside fat tissue before spreading to harm blood vessels and spur insulin resistance.

Dr. Steven Shoelson at the Harvard-affiliated Joslin Diabetes Center noted reports from 150 years ago that one of the oldest anti-inflammatories around -- salsalate, from the aspirin family -- could lower blood sugar. Less harsh on the stomach than aspirin, generic salsalate is used today for arthritis, and Shoelson discovered that it inhibits what he calls a master switch in inflammation regulation.

Pilot trials found that short-term use of salsalate, added to regular diabetes medication, helped people with poorly controlled type II diabetes lower their blood sugar substantially. Fasting glucose levels dropped from about an average of 150 to 110, Shoelson said.

Now a study funded by the National Institutes of Health is recruiting several hundred type II diabetics at 21 medical centers nationwide to take the drug or a dummy pill for a year, to track long-term effects.