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High-sensitivity C-reactive protein and impaired coronary vasoreactivity in young men with uncomplicated type 1
J Sundell1, T Rönnemaa, H Laine
1Turku PET Centre, Turku University Central Hospital, P.O. Box 52, 20521 Turku, Finland. jan.sundell@utu.fi
Insights
In type 1 diabetes, elevated high-sensitivity C-reactive protein (hsCRP) is linked to reduced coronary vasoreactivity, even at slightly increased levels. This finding highlights hsCRP as a potential marker for cardiovascular risk in diabetic individuals.
Area of Science:
- Cardiology
- Endocrinology
- Immunology
Background:
- Elevated high-sensitivity C-reactive protein (hsCRP) is a known risk factor for future coronary events.
- The relationship between hsCRP and coronary vasoreactivity in type 1 diabetes remains unexamined.
Purpose of the Study:
- To investigate the association between hsCRP concentrations and coronary vasoreactivity in young individuals with type 1 diabetes.
- To determine if hsCRP levels correlate with impaired blood flow regulation in the coronary arteries of diabetic subjects.
Main Methods:
- Study included 18 young men with uncomplicated type 1 diabetes, divided into high and low hsCRP groups, and 22 age-matched controls.
- Myocardial blood flow at rest and during adenosine stimulation was measured using positron emission tomography (PET) with oxygen-(15)-labelled water.
- Euglycaemic-hyperinsulinaemic clamp was employed to assess flow dynamics.
Main Results:
- Diabetic subjects with slightly elevated hsCRP showed significantly higher hsCRP levels compared to non-diabetic controls.
- Resting myocardial blood flow was comparable across all groups.
- Adenosine-stimulated coronary blood flow was significantly blunted in diabetic subjects with slightly elevated hsCRP compared to both low hsCRP diabetics and non-diabetic controls.
- A significant inverse correlation was found between hsCRP concentrations and adenosine-stimulated flow in all diabetic subjects (r=-0.70, p=0.001).
Conclusions:
- Even slightly elevated hsCRP concentrations are associated with reduced coronary vasoreactivity in young individuals with uncomplicated type 1 diabetes.
- hsCRP may serve as an early indicator of endothelial dysfunction and increased cardiovascular risk in this population.
- Further research is warranted to explore the mechanisms linking hsCRP to impaired vasoreactivity in type 1 diabetes.
Aims/Hypothesis:
Elevated high-sensitivity C-reactive protein (hsCRP) concentrations indicate increased risk of future coronary events. The association between hsCRP and coronary vasoreactivity has not yet been examined in type 1 diabetic subjects.
Methods:
We studied 18 young men who were non-smokers and who had uncomplicated type 1 diabetes. The diabetic subjects were divided into two groups, according to their median hsCRP concentration, as follows: (i) subjects with slightly elevated hsCRP (median 0.76 mg/l, range 0.47-4.73 mg/l, n=8); and (ii) subjects with low hsCRP (median 0.32 mg/l, range 0.11-0.35 mg/l, n=10). In addition we investigated 22 non-diabetic age-matched subjects (hsCRP: median 0.42 mg/l, range 0.11-1.31 mg/l). Resting myocardial blood flow and hyperaemic adenosine-stimulated flow during euglycaemic-hyperinsulinaemic clamp were determined using positron emission tomography and oxygen-(15)-labelled water.
Results:
Diabetic subjects with slightly elevated hsCRP had significantly higher hsCRP concentrations than non-diabetic subjects (p=0.008). Resting myocardial blood flow was similar (NS) in diabetic subjects with slightly elevated hsCRP (0.79+/-0.19 ml.g(-1).min(-1)) or low hsCRP (0.81+/-0.15 ml.g(-1).min(-1)) and non-diabetic subjects (0.80+/-0.19 ml.g(-1).min(-1)). Adenosine infusion induced a significant increase in blood flow in all study subjects (p<0.001) but was blunted in diabetic subjects with slightly elevated hsCRP (3.42+/-0.61 ml.g(-1).min(-1)) when compared with diabetic subjects with low hsCRP (5.08+/-1.65 ml.g(-1).min(-1), p=0.02) or non-diabetic subjects (4.51+/-1.36 ml.g(-1).min(-1), p=0.04). Adenosine-stimulated flow was inversely correlated with hsCRP concentrations in all diabetic subjects (r=-0.70, p=0.001).
Conclusions/Interpretation:
In young subjects with uncomplicated type 1 diabetes, even slightly elevated hsCRP concentrations are associated with reduced coronary vasoreactivity.
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