Elevated C-Reactive Protein Associates With Early-Stage Carotid Atherosclerosis in Young Subjects With Type 1 Diabetes

Abstract

OBJECTIVE -To evaluate whether low-grade inflammation contributes to early-stage advanced carotid atherosclerosis in young subjects with type 1 diabetes.RESEARCH DESIGN AND METHODS -The mean and maximum (max) intimamedia thicknesses (IMT) of the carotid artery were assessed using ultrasound B-mode imaging in 55 patients with type 1 diabetes (22 men and 33 women, aged 22.1 Ϯ 3.6 years (Ϯ SD), duration of diabetes 14.2 Ϯ 5.7 years) and 75 age-matched healthy nondiabetic subjects (28 men and 47 women). High-sensitive C-reactive protein (hs-CRP) levels were measured with a latex-enhanced immunonephelometer.RESULTS -The patients with type 1 diabetes had significantly higher hs-CRP levels (median 0.35, range 0.05-1.47 mg/l vs. median 0.14, range 0.05-1.44 mg/l; P ϭ 0.001) as well as significantly higher mean IMT and max IMT than the nondiabetic subjects (mean IMT 0.76 Ϯ 0.09 vs. 0.72 Ϯ 0.04 mm, P ϭ 0.003; max IMT 0.84 Ϯ 0.11 vs. 0.77 Ϯ 0.06 mm, P Ͻ 0.0001). Hs-CRP levels were significantly correlated with the mean and max IMT of patients with type 1 diabetes and with the max IMT of nondiabetic patients. Multivariate regression analyses for both diabetic and nondiabetic subjects as a single group showed that hs-CRP levels are independently correlated with the mean IMT and max IMT levels (P ϭ 0.002 and P ϭ 0.023, respectively) as well as with diastolic blood pressure, sex, and duration of diabetes.CONCLUSIONS -Our data indicate that hs-CRP levels are elevated in young patients with type 1 diabetes, possibly corresponding with early-stage advanced carotid atherosclerosis.

Influence of atherosclerosis‐related risk factors on serum high‐sensitivity C‐reactive protein levels in patients with type 2 diabetes: Comparison of their influence in obese and non‐obese patients

“…It has been thought that serum hs‐CRP level leads to the development of atherosclerosis5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Although various new pharmacological approaches have been introduced to reduce hs‐CRP levels17, 18, 19, 20, 21, 22, 23, 24, 25, 26, there are still many cardiovascular diseases all over the world.…”

“…An increase of serum high‐sensitivity C‐reactive protein (hs‐CRP) level likely leads to the development of atherosclerosis. Indeed, it has been reported that hs‐CRP level is associated with carotid atherosclerosis in patients with type 2 diabetes mellitus5, 6, 7, 8, suggesting that hs‐CRP is a useful marker to predict an accelerated atherosclerotic process. It has also been shown that elevated hs‐CRP levels are associated with increased cardiovascular risk9, 10, 11, 12.…”

Identification of Atherosclerotic Changes Using B-Mode Ultrasonography in Nigerian Children with Type 1 Diabetes Mellitus

“…Four (40%) of the diabetics had a value of above 0.8 cm, which was a value of 2 standard deviations above the mean value obtained in a normal population of children in a study done by Hayaishi-Okano R et al [7]. Three The units of measurements were as follows: Age-years, HCY-umol/L, UACR-mg/g, TC and LDL-mmol/L, IMT-cm.…”

“…The computer program calculated the mean values of IMT from three separate images [26]. A value of > or equal to 0.8 cm was adjudged to be thickened; this was a value of 2 standard deviations above the mean value obtained in a normal population of children in a study done by Hayaishi-Okano R et al [7].…”

“…Elevated triglycerides, and albuminuria have also been reported to be associated with vascular complications in diabetes [6]. Several markers have been used reliably to assess atherosclerosis namely carotid intima media thickness (IMT) [7], brachial artery flow mediated dilation (FMD) [8] and femoral IMT with the use of ultrasonography.…”