Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

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.

High fibrinogen-to-albumin ratio with type 2 diabetes mellitus is associated with poor prognosis in patients undergoing percutaneous coronary intervention: 5-year findings from a large cohort

“…FIB, a serum glycoprotein synthesized by the liver with a dimeric molecular structure, plays a crucial role in the inflammatory and coagulation cascade, which contribute to the pathogenesis of coronary atherosclerosis [ 2 , 3 ]. Many literatures have reported the association between FIB and inflammation involved in progression of CAD previously [ 6 , 27 ].…”

“…Inflammation plays a crucial role in coronary atherosclerosis progression [ 1 ]. Increasing evidence has indicated that higher levels of inflammatory biomarkers are associated with increased adverse cardiovascular events in patients with coronary artery disease (CAD) [ 2 – 5 ]. Previous studies suggested that fibrinogen (FIB), a biomarker of inflammation as well as a core component in the coagulation pathway, was an independent risk factor and might predict cardiovascular events in patients with CAD [ 3 , 6 ].…”

“…Inflammation is regarded as the common antecedent of atherosclerosis and diabetes [ 2 , 18 ]. Type 2 diabetes mellitus, a well-established risk factor of CAD, has been previously demonstrated to be closely associated with greater atherosclerotic plaque burden and increased risk of adverse cardiovascular events [ 19 – 21 ].…”

Preparative isolation of maltol glycoside from Dianthus superbus and its anti-inflammatory activity in vitro

“…3 Unrestrained or inappropriate inammation, however, can contribute to the incidence of a range of diseases such as hypertension, obesity, and diabetes. [4][5][6][7] Corticosteroids and non-steroidal anti-inammatory drugs are oen used to treat inammatory conditions. 8 Many recent studies have assessed the anti-inammatory activity of different TCMs.…”

Chronic inflammation and progression of chronic kidney disease in patients with type 2 diabetes

“…Зокрема, своєчасне визначення біомаркерів ураження нирок може покращити стратифікацію ризику виникнення або прогресування ДХН у даної когорти пацієнтів. Відомо, що ЦД ІІ типу асоціюється із хронічним запаленням [46]. Запальна реакція являє собою складний механізм у який залучено безліч клітин і молекул, де власне цитокіни і забезпечують послідовність та завершеність імунної відповіді [47].…”