Association between C reactive protein and microvascular and macrovascular dysfunction in sub-Saharan Africans with
Charles Frederick Hayfron-Benjamin1,2,3, Anke H Maitland-van der Zee4, Bert-Jan van den Born5
1Vascular Medicine, Respiratory Medicine and Public Health, Amsterdam University Medical Centres, Amsterdam, The Netherlands charlesfhb1@gmail.com.
Insights
Elevated C-reactive protein (CRP) is linked to higher diabetes risk in sub-Saharan Africans. Higher CRP also correlates with peripheral artery disease (PAD) in those with and without diabetes, and nephropathy in those without diabetes.
Area of Science:
- Cardiovascular Health
- Metabolic Disorders
- Inflammation Biomarkers
Background:
- Inflammation, indicated by C-reactive protein (CRP), is a known cardiovascular disease risk factor.
- The association between CRP and microvascular/macrovascular dysfunction in diabetic and non-diabetic individuals remains unclear.
- This study investigates CRP's role in diabetes and associated vascular complications in sub-Saharan Africans.
Purpose of the Study:
- To examine the association between CRP levels and diabetes in sub-Saharan Africans.
- To investigate the link between CRP and microvascular (nephropathy) and macrovascular (peripheral artery disease - PAD) dysfunction in individuals with and without diabetes.
- To determine if CRP can serve as a risk assessment marker for diabetes and vascular complications in this population.
Main Methods:
- Cross-sectional analysis of baseline data from the RODAM study involving 5248 Ghanaians.
- Logistic regression models were used to assess associations between CRP Z-scores and diabetes, nephropathy, and PAD.
- Analyses were adjusted for multiple risk factors including age, sex, BMI, blood pressure, and cholesterol levels.
Main Results:
- Higher CRP concentrations were significantly associated with a greater odds of diabetes (adjusted OR 1.13).
- In participants with diabetes, higher CRP was linked to PAD (OR 1.19) but not nephropathy.
- Among non-diabetic participants, higher CRP was associated with increased odds of both PAD (OR 1.10) and nephropathy (OR 1.12).
Conclusions:
- Elevated CRP is associated with increased odds of diabetes in sub-Saharan Africans.
- Higher CRP levels correlate with peripheral artery disease (PAD) in both diabetic and non-diabetic individuals.
- CRP may be a valuable biomarker for assessing the risk of diabetes, PAD, and nephropathy in sub-Saharan African populations.
Introduction:
Although inflammation assessed by elevated C reactive protein (CRP) concentration is known to be associated with risk of cardiovascular disease, its association with microvascular and macrovascular dysfunction in diabetes and non-diabetes remains unclear. We examined the association between CRP and diabetes and associated microvascular and macrovascular dysfunction in sub-Saharan Africans with and without diabetes.
Research Design And Methods:
Cross-sectional analyses of baseline data from the multicenter RODAM study (Research on Obesity and Diabetes among African Migrants) including 5248 Ghanaians (583 with diabetes, 4665 without diabetes) aged 25-70 years were done. Logistic regression analyses were used to examine the associations between CRP Z-scores and diabetes and microvascular (nephropathy) and macrovascular (peripheral artery disease (PAD)) dysfunction, with adjustments for age, sex, site of residence, smoking, body mass index, systolic blood pressure, and low-density lipoprotein cholesterol.
Results:
In the fully adjusted models, higher CRP concentration was significantly associated with diabetes (adjusted OR 1.13; 95% CI 1.05 to 1.21, p=0.002). In participants with diabetes, higher CRP concentration was associated with PAD (1.19; 1.03 to 1.41, p=0.046) but not nephropathy (1.13; 0.97 to 1.31, p=0.120). Among participants without diabetes, higher CRP concentration was associated with higher odds of PAD (1.10; 1.01 to 1.21, p=0.029) and nephropathy (1.12; 1.04 to 1.22, p=0.004).
Conclusions:
In this study, higher CRP concentration was associated with higher odds of diabetes in sub-Saharan Africans. Also, higher CRP concentration was associated with higher odds of nephropathy and PAD in non-diabetes and higher odds of PAD in diabetes. CRP may be an important marker for assessment of risk of diabetes and risk for PAD and nephropathy in sub-Saharan Africans with and without diabetes.
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