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C-reactive protein and glycemic control in adults with diabetes
Dana E King1, Arch G Mainous, Thomas A Buchanan
1Department of Family Medicine, Medical University of South Carolina, Charleston 29425, USA. kingde@musc.edu
Insights
Poor glycemic control, indicated by high HbA1c levels, is linked to increased C-reactive protein (CRP) in individuals with diabetes. This suggests a connection between blood sugar management and systemic inflammation.
Area of Science:
- Endocrinology
- Cardiovascular Disease Research
- Clinical Chemistry
Background:
- Poor glycemic control in diabetes is associated with macrovascular complications.
- C-reactive protein (CRP) is a recognized risk factor for cardiovascular disease.
- Understanding the relationship between glycemic control and inflammation is crucial for diabetes management.
Purpose of the Study:
- To investigate the association between HbA1c levels and C-reactive protein (CRP) concentrations.
- To determine if elevated CRP is linked to poorer glycemic control in a national sample of adults with diabetes.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey III (1988-1994).
- Analyzed a nationally representative sample of 1,018 noninstitutionalized U.S. adults with diabetes.
- Stratified participants by HbA1c levels and assessed elevated CRP (>0.30 mg/dl) as the main outcome.
Main Results:
- Individuals with elevated HbA1c levels (> or =9.0%) showed a significantly higher prevalence of elevated CRP compared to those with low HbA1c (<7%).
- Adjusted regression analysis revealed that higher HbA1c levels (particularly >9.0% and >11.0%) were significantly associated with an increased likelihood of elevated CRP.
- HbA1c also predicted elevated CRP when analyzed as a continuous variable.
Conclusions:
- The likelihood of elevated CRP concentrations rises with increasing HbA1c levels in individuals with diabetes.
- Findings suggest a significant association between glycemic control and systemic inflammation in established diabetes.
- This highlights the potential role of inflammation in diabetes-related complications.
Objective:
Recent evidence suggests that poor glycemic control is significantly associated with the development of macrovascular complications of diabetes. Studies have indicated that C-reactive protein (CRP) is an important risk factor for cardiovascular disease. The purpose of this study was to determine the relation between CRP and HbA(1c) in a large national sample of individuals with diabetes.
Research Design And Methods:
A nationally representative sample of noninstitutionalized U.S. adults aged 17 years and over with nongestational diabetes was derived from the National Health and Nutrition Examination Survey III (1988-1994) (n = 1,018). Respondents with diabetes were stratified by HbA(1c) level. The main outcome measure was elevated (>0.30 mg/dl) CRP.
Results:
In unadjusted analyses, respondents with diabetes who had elevated HbA(1c) levels (> or =9.0%) had a significantly higher percent of elevated CRP than people with low (<7%) HbA(1c) levels (P < 0.001). In adjusted regression analysis, after controlling for age, race, sex, smoking, length of time with diabetes, insulin, and BMI, HbA(1c) was significantly associated with an increased likelihood of elevated CRP for HbA(1c) >9.0% (OR 2.15, 95% CI 1.07-4.32) and for HbA(1c) >11.0% (4.40, 1.87-10.38). Higher HbA(1c) also predicted elevated CRP in the regression model when HbA(1c) was analyzed as a continuous variable (1.20, 1.07-1.34).
Conclusions:
In this study, the likelihood of elevated CRP concentrations increased with increasing HbA(1c) levels. These findings suggest an association between glycemic control and systemic inflammation in people with established diabetes.