Combined Effects of Hemoglobin A _1c and C-Reactive Protein on the Progression of Subclinical Carotid Atherosclerosis

Abstract

Background and Purpose-Glycohemoglobin (hemoglobin A 1c [HbA 1c ]) and high-sensitivity C-reactive protein (hsCRP) are risk indicators for atherosclerosis. Limited information exists regarding the combined effects of inflammation and hyperglycemia. We investigated the joint effects of both parameters on early carotid atherosclerosis progression and major vascular events in diabetic and nondiabetic subjects. Methods-We analyzed the data of INVADE (Intervention Project on Cerebrovascular Diseases and Dementia in the Community of Ebersberg, Bavaria), a prospective, population-based study conducted in 3534 subjects (mean age, 69 years). In addition to common risk factors, measurements of carotid intima-media thickness (IMT), hsCRP, and HbA 1c were performed at baseline and after 2 years of follow-up. Results-For the entire population, IMT progression was significantly related to HbA 1c (Pϭ0.003) but not to hsCRP (Pϭ0.06) after risk factor adjustment. The interaction hsCRPϫHbA 1c was highly significant (Pϭ0.001), and the most pronounced IMT progression was seen in subjects with both parameters in the fourth quartiles compared with subjects with both parameters in the first quartiles (0.

Association of C-reactive Protein with Early-stage Carotid Atherosclerosis in Japanese Patients with Early-state Type 2 Diabetes Mellitus

“…Several studies have examined the relation between hsCRP and CCA-IMT in patients with type 2 diabetes mellitus [10,11,17]. However, there are no data on whether hs-CRP is a better predictor for subclinical atherosclerosis relative to other factors directly associated with insulin resistance.…”

“…However, there are no data on whether hs-CRP is a better predictor for subclinical atherosclerosis relative to other factors directly associated with insulin resistance. Recently, Sander et al reported that hs-CRP is one determinant of CCA-IMT as evaluated by multiple regression analysis [10]. However, indexes of insulin resistance such as HOMA-IR and fasting insulin were not included in their analysis.…”

“…On the other hand, only a few studies showed the correlation between hs-CRP and the degree of IMT in patients with type 2 diabetes mellitus [10]. Several studies reported that hs-CRP does not independently correlate with subclinical atherosclerosis in type 2 diabetes [11].…”

Association between the Lipoprotein-Associated Phospholipase A2 Activity and the Progression of Subclinical Atherosclerosis

“…This study is embedded in the CMCS, a nationwide population-based study that aimed to investigate risk factors related to the incidence of CVD 13) . Of the 1,982 subjects originally selected for the CMCS trial using stratified random sampling for each sex and 10-year age group in a community in Beijing in 1992, 1,324 subjects ranging from 45 to 74 years of age took part in an examination of cardiovascular risk factors and carotid B-mode ultrasound in veys 15) . The presence of plaque was defined as an IMT of ≥ 1.3 mm or a focal structure that encroached into the arterial lumen measuring at least 0.5 mm or 50% of the surrounding IMT.…”

C-reactive protein mediates the association of liver fat and carotid intima–media thickness in healthy men and men with the metabolic syndrome and/or uncomplicated type 2 diabetes

“…CRP is marked as an independent predictor of future CVD events [14][15][16]. Therefore, this pro-inflammatory phenotype may underlie the association between liver fat and CVD risk.…”