hsCRP may improve cardiovascular risk prediction
MedWire News: High-sensitivity C-reactive protein (hsCRP) is an independent predictor of cardiac risk in patients with Type 2 diabetes who have a normal lipid profile, research shows.
The team found that patients with diabetes with hsCRP levels above 3 mg/L had a 10-fold higher cardiac risk compared with their healthy counterparts without diabetes.
"We propose that patients with Type 2 diabetes with normal lipid profile[s] and increased hsCRP levels… should be targeted for therapeutic lifestyle changes and also therapeutic agents like statins," comment Shilpa Asegaonkar (Government Medical College, Aurangabad, India) and colleagues in the Journal of Diabetes and Its Complications.
The researchers recruited 60 individuals with diabetes with normal lipid levels (total cholesterol <200 mg/dL [5.18 mmol/L], low-density lipoprotein [LDL] cholesterol <100 mg/dL [2.59 mmol/L], high-density lipoprotein [HDL] cholesterol >60 mg/dL [1.55 mmol/L], and triglycerides <150 mg/dL [1.69 mmol/L]) and 60 age- and gender-matched healthy controls without diabetes. All patients were aged 45-65 years and had their lipid profile and serum levels of hsCRP assessed.
Asegaonkar et al found that patients with diabetes had significantly higher mean hsCRP levels than controls, at 4.8 versus 0.9 mg/L.
When they categorized participants into three cardiovascular risk groups depending on their levels of hsCRP, they found that among patients with diabetes, seven were at low cardiovascular risk (0-1 mg/L), 32 at moderate risk (1-3 mg/L), and 21 at high risk (>3 mg/L). By contrast, 49 individuals in the control group were at low risk, eight at moderate risk, and three at high risk.
Furthermore, 21 individuals in the group with diabetes had a mean hsCRP level above 3 mg/L compared with just three from the control group. The authors say that this corresponds to an odds ratio of 10.23 for high cardiac risk among patients with diabetes compared with controls.
"For identifying persons at high risk for future cardiovascular events, the addition of [a] serum hsCRP assay to standard lipid profile evaluation may provide a simple, inexpensive, and noninvasive screening tool, especially in individuals with LDL of <100 mg/L and hsCRP level of >3 mg/L," they say.
"For such a high-risk group, which remains underestimated for cardiac risk in clinical practice, serum hsCRP along with traditional cardiac risk factor evaluation may improve global risk cardiac predication and definitely improve the diagnostic and therapeutic outcome of diabetics," concludes the team.
By Nikki Withers