C-reactive protein: a marker or a player?

2007 ◽  
Vol 113 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Thomas Nyström

It has been suggested that Type 2 diabetes may, in part, be precipitated or accelerated by an acute-phase reaction as part of the innate immune response, in which large amounts of cytokines are released from adipose tissue, creating a low-grade inflammatory milieu. There is also firm evidence that atherosclerosis is an immune-mediated inflammatory disease. Therefore it is reasonable to imply that low-grade inflammation is an important pathogenetic factor in atherosclerosis and cardiovascular events in patients with Type 2 diabetes. Over the last few years, there have been a lot of promising clinical markers proposed to link inflammation and atherosclerosis. Of these markers, hs-CRP (high-sensitivity C-reactive protein) might be a prognostic marker for further cardiovascular events, although this has been refuted recently. In this issue of Clinical Science, Castoldi and co-workers have demonstrated that, in patients with Type 2 diabetes categorized into low (<1.0 mg/l), medium (1.0–3.0 mg/l) and high (>3.0 mg/l) hs-CRP groups, serum levels of hs-CRP correlated with lipopolysaccharide-stimulated release of interleukin-1β and interleukin-6 in whole blood. This finding may indicate that low-grade inflammatory activity might influence cytokine production in these patients.

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Amanda L. Missel ◽  
Laura R. Saslow ◽  
Dina H. Griauzde ◽  
Donna Marvicsin ◽  
Ananda Sen ◽  
...  

Abstract Introduction Chronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes. Hyperglycemia is associated with chronic low-grade inflammation, and thus has become the focus of many screening and treatment recommendations. We hypothesize that insulin may also be associated with inflammation and may be an additional factor to consider in screening and treatment. Methods This study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). A two-part model was used due to the high number of values reported as 0.1 mg/L. Two models were analyzed, both with and without the addition of waist circumference to other covariates in the model. Results The final sample included 4527 adults with a mean age of 43.31 years. In the first model, higher fasting insulin was associated with increased odds of CRP > 0.1 mg/L (OR = 1.02, p < .001) and with higher CRP (β = 0.03, p < .001). In the adjusted model, including waist circumference as a covariate, higher fasting insulin was not associated with CRP > 0.1 mg/L (OR = 1.00, p = .307) but the association between higher fasting insulin and higher continuous CRP remained significant (β = 0.01, p = .012). Conclusion This study found that higher fasting insulin is associated with higher CRP. These results suggest that treatment approaches that simultaneously decrease insulin levels as well as glucose levels may provide additive anti-inflammatory effects, and therefore may improve long-term outcomes for adults with type 2 diabetes.


1970 ◽  
Vol 11 (1) ◽  
pp. 20-23
Author(s):  
AKM Fazlul Haque ◽  
ARM Saifuddin Ekram ◽  
Quazi Tarikul Islam ◽  
Md Sarwar Jahan ◽  
Md Zahirul Haque

Type-2 diabetes may remain in subclinical form for years before diagnosis. This quiescence of type-2 diabetes is a great concern for health care providers. The earliest change of the type-2 diabetes is the insulin resistance, which is associated with the increased macrovascular risk due to induction of chronic inflammation in the vessels of the body which leads to atherosclerotic change in the vessels. High sensitivity CRP (hs-CRP) is the measure of C-reactive protein with greater accuracy and the lower limit of its assay is .01 mg/L which is more than 100 times as sensitive as the usual CRP measurement (lower limit 5 mg/L). The median level of hs-CRP from blood samples of apparent healthy subjects is 0.8 mg/L. For this, physician uses the hs-CRP parameter as a marker of chronic inflammation in apparently normal healthy individuals, specially for the assessment of atherosclerosis, which is a chronic inflammatory procedure from the very beginning, in type-2 diabetic, obese and hypertensive patients. This vascular atherosclerosis assessment help them to calculate the cardiovascular as well as cerebrovascular risk of those patients. To help the type-2 diabetic patients from the very begining in respect of the prognostic view of the macrovascular risk, estimations of serum hs-CRP in the early stage of these patient may be a enthusiastic one. This descriptive study was carried out by choosing 70 diabetic patient who had no other comorbidity or any complications of diabetes and 35 healthy subjects who were neither diabetic nor had any diseases. Both the groups were non-smoker and non-alcoholic and non-hypertensive, hs-CRP level was measured in both the groups along with the HbA1c%. The mean hs-CRP in diabetic group was 1.13 mg/L and in normal healthy subjects was 0.39 mg/L. This higher level of mean hs-CRP (1.13 mg/L) in diabetic patients is statisticaly significant (P<0.01) compared with that of the normal healthy subjects mean hs-CRP (0.39 mg/L). This mean level of hs-CRP in normal healthy subjects was below the lower level of cardiovascular risk (1 mg/L). Keywords: High sensitivity CRP, C-reactive protein, diabetes DOI:10.3329/jom.v11i1.4263 J Medicine 2010: 11: 20-23


Author(s):  
Ummugulsum Can ◽  
Muammer Buyukinan ◽  
Asuman Guzelant ◽  
Ayse Ugur ◽  
Adnan Karaibrahimoglu ◽  
...  

AbstractBackground:Metabolic syndrome (MetS) is a chronic and multifactorial syndrome characterized by a low-grade chronic inflammation, and a major risk factor for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In our study, we aimed to investigate the serum levels of high sensitive C-reactive protein (hs-CRP), haptoglobin (Hp), αMethods:This study was performed in 43 (18 males, 25 females) MetS adolescents between the ages of 13 and 17 years (14.70±1.15) and 43 lean controls were matched for age and sex. The serum levels of Hp, αResults:Serum Hp, fetuin-A (p<0.01) and PF-4, hs-CRP, SAP, AGP (p<0.001) values of the MetS subjects were significantly higher than those of the controls. No difference was found in serum αConclusions:This finding suggests the possibility of using these markers in diagnosis of MetS in adolescents to prevent future complications.


2014 ◽  
Vol 33 (4) ◽  
pp. 347-355
Author(s):  
Ljiljana Popović ◽  
Katarina Lalić ◽  
Olga Vasović ◽  
Danijela Drašković Radojković ◽  
Nataša Rajković ◽  
...  

Summary Background: Previous studies have indicated that high sensitivity C-reactive protein (hs-CRP) is a risk factor for the peripheral arterial disease (PAD) in diabetes. This study aimed to evaluate the possible predictive significance of hs-CRP for the development and progression of PAD in patients with type 2 diabetes (T2D). Methods: The study included 80 patients previously diagnosed with T2D, aged 45–70 years, divided into group A (T2D patients with PAD; n=38) and group B (T2D patients without PAD; n=42). After five years, all the patients were re-examined and divided into subgroups depending on de novo development of PAD or progression of previously diagnosed PAD. Ankle-Brachial Index (ABI) measurement was used for PAD diagnosis and hs-CRP was determined by nephelometry. Results: We found significantly higher hs-CRP levels in group A compared to group B, but only at baseline. Among the patients in group A, those with later progression of PAD (subgroup A1) had the highest levels of hs-CRP at baseline, although not significantly different from those in subgroup A2 (non-progressors). In contrast, hs-CRP level was significantly higher in subgroup B1 (progressors) in comparison to subgroup B2 (non-progressors) at both the first and second exam. Of all the investigated metabolic parameters, hs-CRP was the only independent predictor of PAD progression (OR=0.456, 95% CI=0.267–0.7815, p=0.004). The cut-off point for hs-CRP was 2.5 mg/L (specificity 75% and sensitivity 73.3%) with the relative risk for PAD of 2.93 (95% CI=1.351–6.3629). Conclusions: Our study implies that hs-CRP can be used as a reliable predictor for the progression of PAD in patients with T2D.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shahnam Sharif ◽  
Y. Van der Graaf ◽  
M. J. Cramer ◽  
L. J. Kapelle ◽  
G. J. de Borst ◽  
...  

Abstract Background Type 2 diabetes is a condition associated with a state of low-grade inflammation caused by adipose tissue dysfunction and insulin resistance. High sensitive-CRP (hs-CRP) is a marker for systemic low-grade inflammation and higher plasma levels have been associated with cardiovascular events in various populations. The aim of the current study is to evaluate the relation between hs-CRP and incident cardiovascular events and all-cause mortality in high-risk type 2 diabetes patients. Methods Prospective cohort study of 1679 type 2 diabetes patients included in the Second Manifestations of ARTerial disease (SMART). Cox proportional hazard models were used to evaluate the risk of hs-CRP on cardiovascular events (composite of myocardial infarction, stroke and vascular mortality) and all-cause mortality. Hs-CRP was log-transformed for continuous analyses. Findings were adjusted for age, sex, BMI, current smoking and alcohol use, non-HDL-cholesterol and micro-albuminuria. Results 307 new cardiovascular events and 343 deaths occurred during a median follow-up of 7.8 years (IQR 4.2–11.1). A one unit increase in log(hs-CRP) was related to an increased vascular- and all-cause mortality risk (HR 1.21, 95% CI 1.01–1.46 and HR 1.26, 95% CI 1.10–1.45 respectively). No relation was found between log(hs-CRP) and myocardial infarction or stroke. The relations were similar in patients with and without previous vascular disease. Conclusion Low grade inflammation, as measured by hs-CRP, is an independent risk factor for vascular- and all-cause mortality but not for cardiovascular events in high-risk type 2 diabetes patients. Chronic low-grade inflammation may be a treatment target to lower residual cardiovascular risk in type 2 diabetes patients.


2007 ◽  
Vol 51 (6) ◽  
pp. 956-960 ◽  
Author(s):  
Luciana M. Lima ◽  
Maria das Graças Carvalho ◽  
Anna L. Soares ◽  
Adriano de P. Sabino ◽  
Ana P. Fernandes ◽  
...  

Type 2 diabetes mellitus (DM2) and high blood pressure (HBP) may contribute to the development of cardiovascular disease, and inflammation may be an important factor in these diseases. In the present study, plasma levels of high-sensitivity C-reactive protein (hs-CRP) were measured in subjects with DM2 and/or HBP and compared to those of normal subjects. Eighty-nine subjects were analyzed for hs-CRP, including 13 normotensive patients with DM2, 17 patients with HBP, 34 hypertensive patients with DM2 (DM2+HBP) and 25 normal subjects. The plasma hs-CRP levels were significantly lower in the controls than in the HBP+DM2 group (p < 0.05). DM2 associated with HBP was also correlated with increased plasma hs-CRP levels (n = 89, r = 0.25, p = 0.0162). Only hypertensive patients with DM2 had higher levels of hs-CRP, a circulating inflammatory marker, than normal subjects. This finding suggests that patients with two associated diseases have a more active inflammatory state.


2007 ◽  
Vol 7 (4) ◽  
pp. 322-327 ◽  
Author(s):  
Asija Začiragić ◽  
Jasminko Huskić ◽  
Almira Hadžović-Džuvo ◽  
Amina Valjevac ◽  
Nesina Avdagić ◽  
...  

We investigated serum concentration of C-reactive protein (CRP) and measures of adiposity in 30 patients with type 2 diabetes mellitus (15 male, 15 female) and 30 age and sex-matched apparently healthy subjects.CRP concentration was determined by laser nephelometry (BN II Analyzer) and CardioPhase high-sensitivity CRP (DADE BEHRING) was used as reagent which consists of polystyrene particles coated with mouse monoclonal antibodies to CRP.Results have shown that serum CRP concentration in patients with type 2 diabetes mellitus was statistically significantly higher compared to control group of healthy subjects (p<0,05). Body mass index (BMI) correlated significantly with serum concentration of CRP in patients with type 2 diabetes mellitus (r=0,614; p<0,001). Statistically significant positive correlation was also found between waist to hip ratio and serum CRP concentration in patients with type 2 diabetes mellitus (r=0,426; p<0,05).Elevated serum CRP concentration in patients with type 2 diabetes mellitus is probably caused by the presence of chronic low-grade inflammation in these patients. It is possible that determined increase of CRP concentration reflects activation of innate immune system components in patients with type 2 diabetes mellitus. Implications of established association between measures of adiposity and serum CRP level in type 2 diabetes mellitus remain unclear.


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