Q J Med 2000; 93: 231-236
© 2000 Association of Physicians
Determinants of raised C-reactive protein concentration in type 1 diabetes
From the Department of Clinical Biochemistry, Hull Royal Infirmary, Hull, 1 Department of Clinical Biochemistry, Wythenshawe Hospital, Manchester, 2 Department of Clinical Biochemistry, Royal Preston Hospital, Preston, and 3 Department of Clinical Biochemistry, and 4 The Diabetes Unit, Gartnavel General Hospital, Glasgow, UK
Received 19 November 1999 and in revised form 18 January 2000
As a marker of systemic inflammation, raised C-reactive protein (CRP) concentrations which are still within the normal range have been associated with an increased incidence of coronary heart disease (CHD) in non-diabetic subjects. This study aimed to establish potential determinants of raised CRP concentrations in type 1 diabetic patients. We used a sensitive assay to measure ‘low-level’ CRP concentrations in 167 type 1 patients (93M, 74F, median age 30 years, range 13–67). Stepwise multivariate analysis was used to relate these CRP levels to known cardiovascular risk factors and demographic data. Only six patients had established CHD (median CRP 3.34 mg/l vs. 0.83 mg/l, p=0.032). In subjects without overt CHD, multivariate analysis showed increases in subject age (p=0.0025), BMI (p=0.001) and HbA1 (p=0.012) to be associated with a higher CRP concentration, as was female sex (p=0.026) and a history of CHD in a first-degree relative (p=0.018, n=57). The duration of diabetes, current smoking status, presence of microvascular complications, lipid status and presence of hypertension were unrelated. This study suggests that some of the risk factors associated with CHD in type 1 patients are also independently predictive of high CRP concentrations. The reasons for this, and whether intervention would prove useful, require further investigation.
Address correspondence to Dr E.S. Kilpatrick, Department of Clinical Biochemistry, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ. e-mail: eric\|[hyphen]\|kilpatrick{at}hotmail.com
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