Elevated High Sensitivity C-Reactive Protein Is Associated with Type 2 Diabetes Mellitus: The Persian Gulf Healthy Heart Study

Abstract

Abstract. Previous studies have suggested that low-grade systemic inflammation is involved in the pathogenesis of type 2 diabetes mellitus. However, limited information is available about the relationship of diabetes mellitus and inflammation in Asia. We examined the association between high-sensitivity C-reactive protein (CRP) levels and diabetes in a general Iranian population. In an ancillary study to the Persian Gulf Healthy Heart Study, a cohort study of men and women aged ≥25 years, a random sample of 1754 (49.2 percent males, 50.8 percent females) subjects were evaluated. High sensitivity C-reactive protein was measured by enzyme-linked immunosorbent assay. Elevated serum CRP was defined as more than 3.0 mg/l. The diabetes classification was based on the criteria of the American Diabetes Association. A total of 8.6 percent of the subjects (8.0 percent of males & 9.1 percent of females; p>0.05) had type 2 diabetes mellitus. Geometric mean of CRP was 1.94 mg/l (3.80 SD) in the studied population. The subjects with diabetes had a higher geometric mean of CRP levels than the subjects with no diabetes [3.67 (SD 3.71) versus 1.85 (3.83) respectively; p<0.0001)]. In multiple logistic regression analysis, diabetes showed a significant age-adjusted association with elevated CRP levels [Odds Ratio = 2.03, Confidence Interval (1.38-2.98); p<0.0001] after adjusting for sex, LDL-cholesterol, HDL-cholesterol blood pressure, smoking and body mass index. In conclusion, beyond traditional cardiovascular risk factors, elevated CRP is significantly correlated with diabetes in general population of the northern Persian Gulf. Further insight into the specific effects of proinflammatory cytokines and acute-phase proteins will be essential for the development of new preventive strategies for diabetes mellitus.

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Obesity in the Natural History of Type 1 Diabetes Mellitus: Causes and Consequences

“…Hyperhomocysteinemia, known risk factor for coronary atherosclerosis (Okada et al, 1999), has also been shown to be detrimental to pancreatic insulin secretion (Patterson et al, 2006). The C-reactive protein (CRP), an inflammatory marker that confers increased risk for atherosclerosis (Hayaishi-Okano et al, 2002), is increased in T2D patients (Nabipour et al, 2008) and obese subjects (Richardson et al, 2009), and also relates to the control of diabetes (King et al, 2003), i.e. may increase due to the weight gain caused by intensive control of diabetes (Schaumberg et al, 2005).…”

High sensitivity C-reactive protein is associated with the metabolic syndrome independent to viral and bacterial pathogen burden

“…The design of this study encompasses two major components: phase I is a crosssectional prevalence study of unhealthy lifestyle and ischemic heart disease and associated risk factors, and phase II is a multiple interventional project for reduction of cardiovascular diseases in the region. Detailed information about the methods and procedures of this study is available elsewhere [28]. In an ancillary study to the Persian Gulf Healthy Heart Study, a total of 1754 (49.2% males, 50.8% females) subjects were selected through a stratified multistage design from major ports of Bushehr Province (an Iranian province with the greatest boarder with the Persian Gulf).…”