STUDY TO DETERMINE THE ASSOCIATION BETWEEN INFLAMMATORY MARKER (C-REACTIVE PROTEIN) AND HBA1C IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Rakesh Kumar Nirala; Jyoti Priya

doi:10.22159/ajpcr.2024.v17i1.49715

Authors

Rakesh Kumar Nirala Department of Pathology, Patna Medical College and Hospital, Patna, Bihar, India.
Jyoti Priya Department of Physiology, Nalanda Medical College and Hospital, Patna, Bihar, India.

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i1.49715

Keywords:

C-reactive protein, Correlation, Glycaemic control, hsCRP, HbA1c

Abstract

Objectives: Patients with type 2 diabetes exhibit subclinical inflammation and nearly all signs of systemic inflammation, which characterized by high circulating levels of inflammatory parameters. The present study aimed to assess the levels of the inflammatory markers such as C-reactive protein (CRP) in patients with type 2 diabetes mellitus and to correlate their values with the hemoglobin A1c (HbA1c) levels.

Methods: This cross-sectional study was conducted on 78 patients with type 2 diabetes in Patna Medical College and Hospital, Patna. All patients had laboratory investigations including HbA1C and CRP, patients were assessed according to glycemic status, patients with under control of diabetics (HbA1C level was equal to or <6.5%), and patients with poorly-controlled diabetics (HbA1c level was >6.5%).

Results: Statistically significant association was observed between CRP levels and level of HbA1c. The CRP level was significantly higher in poorly-controlled diabetic patient than who with well-controlled diabetics (p=0.017).

Conclusions: There is positive correlation between the level of glycemic control (HbA1c) and CRP levels; better glycemic control results in significant reduction in the highly sensitive C-reactive protein levels.

Downloads

Download data is not yet available.

References

Saudek CD, Kalyani RR, Derr RL. Assessment of glycemia in diabetes mellitus: Hemoglobin A1c. J Assoc Physicians India 2005;53:299-305.

Cavero-Redondo I, Peleteiro B, Álvarez-Bueno C, Rodriguez-Artalejo F, Martínez-Vizcaíno V. Glycated haemoglobin A1c as a risk factor of cardiovascular outcomes and all-cause mortality in diabetic and non-diabetic populations: A systematic review and meta-analysis. BMJ Open 2017;7:e015949.

Kamath DY, Xavier D, Sigamani A, Pais P. High sensitivity C-reactive protein (hsCRP) & cardiovascular disease: An Indian perspective. Indian J Med Res 2015;142:261-8.

Pfützner A, Forst T. High-sensitivity C-reactive protein as cardiovascular risk marker in patients with diabetes mellitus. Diabetes Technol Ther 2006;8:28-36.

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetesprevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019;157:107843.

International Diabetes Federation. IDF Diabetes Atlas. 8th ed. Brussels, Belgium; 2017. [Last accessed on 2022 Aug 08]. Available from website.

Gohel MG, Chacko AN. Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control: An evidence linking oxidative stress, inflammation and glycemic control. J Diabetes Metab Disord 2013;12:56.

Lee YS, Moon SS. The use of HbA1c for diagnosis of type 2 diabetes in Korea. Korean J Med 2011;80:291-7.

Emerging Risk Factors Collaboration, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: A collaborative meta-analysis of 102 prospective studies. Lancet 2010;375:2215-22.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37:S81-90.

Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28:169-80.

Muhammad R, Masood A, Zaffar J, Butt U. Correlation of mean HbA1c levels with severity of coronary arteries disease in diabetics. Pak Heart J 2014;47:184-7.

Hu G, Jousilahti P, Tuomilehto J, Antikainen R, Sundvall J, Salomaa V. Association of serum C-reactive protein level with sex-specific type 2 diabetes risk: A prospective Finnish study. J Clin Endocrinol Metab 2009;94:2099-105.

Pichandi S, Janakiraman P, Muraliswaran P, Prabhu G. Study the association of the cardiac risk indices and high sensitive C-reactive protein for type 2 diabetes patients in tertiary care hospital, Puducherry. Asian J Med Sci 2022;13:64-8.

Ahmed M, Islam MM, Rahman MA, Rubaiyat KA, Khuda CM, Ferdous KA, et al. Correlation between inflammatory marker and glycemic control in patients with ischemic heart disease. Bangladesh Heart J 2018;33:100.

Khera A, McGuire DK, Murphy SA, Stanek HG, Das SR, Vongpatanasin W, et al. Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 2005;46:464-9.

Lakoski SG, Cushman M, Criqui M, Rundek T, Blumenthal RS, D’Agostino RB Jr., et al. Gender and C-reactive protein: Data from the multiethnic study of atherosclerosis (MESA) cohort. Am Heart J 2006;152:593-8.

Cartier A, Côté M, Lemieux I, Pérusse L, Tremblay A, Bouchard C, et al. Sex differences in inflammatory markers: What is the contribution of visceral adiposity Am J Clin Nutr 2009;89:1307-14.

Kwok S, Canoy D, Ashton WD, Lowe GD, Wood D, Humphries SE, et al. Increased C-reactive protein levels in overweight and obese women taking exogenous hormones: The United Kingdom Women’s Heart Study (UKWHS). Clin Endocrinol (Oxf) 2009;71:727-32.

Albert MA, Glynn RJ, Ridker PM. Plasma concentration of C-reactive protein and the calculated Framingham Coronary Heart Disease Risk Score. Circulation 2003;108:161-5.

King DE, Mainous AG 3rd, Buchanan TA, Pearson WS. C-reactive protein and glycemic control in adults with diabetes. Diabetes Care 2003;26:1535-9.

Fawaz L, Elwan A, Kamel Y, Farid T, Kamel A, Mohamed W. Clinical research value of C-reactive protein and IL-6 measurements in type1 diabetes mellitus. Arch Med Sci 2009;5:383-90.

Schölin A, Siegbahn A, Lind L, Berne C, Sundkvist G, Björk E, et al. CRP and IL-6 concentrations are associated with poor glycemic control despite preserved beta-cell function during the first year after diagnosis of type 1 diabetes. Diabetes Metab Res Rev 2004;20:205-10.

Hansen TK, Thiel S, Knudsen ST, Gravholt CH, Christiansen JS, Mogensen CE, et al. Elevated levels of mannan-binding lectin in patients with type 1 diabetes. J Clin Endocrinol Metab 2003;88:4857-61.

Schalkwijk CG, Chaturvedi N, Twaafhoven H, VanHinsbergh VW, Stehouwer CD. Amadori-albumincorrelates with microvascular complications and precedes nephropathy in type 1 diabetic patients. EurJ Clin Invest 2002;32:500-6.