A study to assess the predictive value of CRP in detecting type-II diabetes mellitus with nephropathy

Abstract

To assess C reactive protein (CRP) in detecting type-II diabetes mellitus with nephropathy. Patients with a history of diabetes type 2 with nephropathy and patients with diabetes type 2 without nephropathy were included in the study. A total of 30 cases, both male and female, were recruited and compared with30 normal healthy adults. Each participant (age, gender, BMI, i.e. body mass index and WHR, i.e. waist-hip ratio) were recorded. CRP was measured by immunoturbidimetric method. Total cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol were measured by the CHOD-POD method, GPO-PAP method, and CHOD-POD/phosphotungstic method. Low-density lipoprotein (LDL)cholesterol and very low-density cholesterol were measured by Friedewald formula. Lipoprotein ratios ware also calculated. CRP was significantly (p=0.0001) higher among cases (12.60±3.30) compared to controls (5.47±4.29). CRP >9.5 correctly (efficacy) predicted DM2 with DN among 46.7% cases with sensitivity and specificity of 93.3 (95%CI=84.4-102.3) and 76.7 (95%CI=61.5-91.8) respectively. The area under the curve (AUC) was also high (AUC=0.85, 95%CI=0.75-0.95). There was a poor correlation of CRP with lipid profile among DM-2 with DN. Linear regression analysis showed that lipid biomarkers such as HDL, LDL, VLDL & total cholestarol-to-HDL ratio as well as BMI and WHR were positive predictors of CRP after adjusted for age and sex. In turn, HDL, LDL, VLDL and TC to HDL ratio level were a negative predictive factor of CRP levels. The increase of 1 unit on HDL was associated with a reduction of 1.25 in CRP levels. However, all the predictors had no statistical significance (p>0.05). In this study, the level of CRP was higher among cases compared to controls. This study also found that CRP >9.5 had good sensitivity and specificity in predicting DM2 with DN.