Association Between C-Reactive Protein Levels and Glycemic Control Markers in Type 2 Diabetes Mellitus Patients
DOI:
https://doi.org/10.71147/cnh43744Keywords:
C-reactive Protein, Type 2 Diabetes Mellitus, Fasting Blood Sugar, HbA1c, Inflammation, Glycemic Control.Abstract
Background: Systemic inflammation is a key pathophysiological feature of Type 2 Diabetes Mellitus (T2DM). C-reactive protein (CRP), a sensitive marker of inflammation, has been linked to T2DM risk factors, but its direct association with glycemic control markers remains inconsistent in the literature. Objective: This study aimed to investigate the association between CRP status and glycemic control as measured by fasting blood sugar (FBs) and glycated hemoglobin (HbA1c) in patients with T2DM. A secondary objective was to explore the relationship between CRP and various demographic, hematological, and lifestyle characteristics. Methods: A cross-sectional study was conducted on 119 patients diagnosed with T2DM. Participants were categorized as either CRP-positive or CRP-negative based on laboratory analysis. Data on demographics, hematological indices, iron status, and lifestyle factors were collected. Statistical analyses were performed to compare glycemic markers and other variables between the two CRP groups. Results: Of the 119 participants, 36 (30.3%) were CRP-positive and 83 (69.7%) were CRP-negative. The results demonstrated no statistically significant difference in FBs or HbA1c levels between the CRP-positive and CRP-negative groups. Furthermore, there was no significant association found between CRP status and demographic data (age, sex), hematological parameters, or self-reported lifestyle factors, including exercise habits, dietary patterns, and smoking status. Conclusion: In this patient cohort, CRP status alone was not a reliable indicator of glycemic control. The absence of a significant association suggests that the relationship between low-grade systemic inflammation, as measured by CRP, and glucose regulation in T2DM is complex and may be influenced by other unmeasured factors
References
Ahmed M, Rahman T, Noor S. C-reactive protein as a marker of inflammation in type 2 diabetes mellitus: pathophysiological and clinical insights. J Clin Endocrinol Metab. 2023;108(2):456–462.
Alam F, Siddiqui R, Khan A, et al. Inflammatory biomarkers and glycemic parameters in type 2 diabetes: A cross-sectional analysis. J Diabetes Inflamm. 2022;14(1):45–52.
Altaf Q, Barnett AH, Tahrani AA. Novel biomarkers for cardiovascular risk prediction in type 2 diabetes. Diabetologia. 2021;64(3):491–506. https://doi.org/10.1007/s00125-020-05322-5
Brown L, Thomas G, Hassan K. Obesity and inflammation: the link to elevated CRP levels in diabetic populations. Diabetes Res Clin Pract. 2022;185:109239.
Chen Y, Li J, Wang M. Smoking and systemic inflammation: a longitudinal study of CRP levels in patients with T2DM. Tob Induc Dis. 2020;18:89.
Chen Y, Li X, Wang Y, Liu J. Association between CRP levels and type 2 diabetes risk: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2021;176:108829. https://doi.org/10.1016/j.diabres.2021.108829
Chen Z, Sun J, Zhu X, Wang M. Inflammatory cytokines and their relationship with insulin resistance in type 2 diabetes mellitus. Front Endocrinol. 2022;13:834212. https://doi.org/10.3389/fendo.2022.834212
Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2021 and projections for 2045. Diabetes Res Clin Pract. 2021;183:109119. https://doi.org/10.1016/j.diabres.2021.109119
DeFronzo RA, Ferrannini E, Groop L, et al. Type 2 diabetes mellitus. Nat Rev Dis Primers. 2020;6(1):1–31. https://doi.org/10.1038/s41572-020-00214-7
Duan W, Sun L, Yu Y, Ma Y. Association between C-reactive protein and insulin resistance in type 2 diabetes: A cross-sectional study. Diabetes Metab Syndr. 2023;17(1):102597. https://doi.org/10.1016/j.dsx.2022.102597
Gao F, Zhang D, Liu Y. Elevated C-reactive protein levels and risk of cardiovascular disease in patients with type 2 diabetes: A meta-analysis. Cardiovasc Diabetol. 2023;22(1):57. https://doi.org/10.1186/s12933-023-01764-2
Gao Y, Lin Z, Hou X, et al. Physical activity and inflammatory biomarker levels in patients with type 2 diabetes: A community-based study. J Diabetes Metab Disord. 2022;21(1):12–20.
Garcia A, Duran M, Singh H. High-sensitivity C-reactive protein as a predictor of cardiovascular events in type 2 diabetes: a meta-analysis. Cardiovasc Diabetol. 2023;22(1):56.
Gopalakrishnan R, Menon S, Kumar A, et al. Impact of lifestyle modification on inflammatory biomarkers in type 2 diabetic patients. Endocr Metab Sci. 2022;11:100125.
IDF – International Diabetes Federation. IDF Diabetes Atlas, 10th Edition. Brussels, Belgium: IDF; 2023. Available from: https://diabetesatlas.org
Islam MS, Nasir A, Ahmed R, et al. Association of hs-CRP with HbA1c and fasting glucose among diabetic patients. J Clin Lab Res. 2023;17(2):101–107.
Khan N, Farooq H, Abbas M. Alcohol consumption and inflammatory markers in diabetic patients: a case-control study. Alcohol Alcohol. 2021;56(1):103–109.
Kim MK, Han K, Lee SH, Kwon HS. Inflammation as a predictor of cardiovascular risk in patients with diabetes. J Clin Endocrinol Metab. 2022;107(2):390–398. https://doi.org/10.1210/clinem/dgab722
Kim SH, Park J, Lee Y, et al. Association between lifestyle factors and systemic inflammation in type 2 diabetic patients: A cross-sectional study. BMC Endocr Disord. 2023;23:85.
Lee S, Kim JH, Choi Y. Hypertension and elevated CRP in patients with metabolic syndrome and diabetes. J Hypertens. 2019;37(10):2025–2031.
Lee YJ, Kim HC, Cho EJ. C-reactive protein and its relationship with insulin sensitivity and endothelial dysfunction in diabetes. Diabetes Vasc Dis Res. 2021;18(5):14791641211043598. https://doi.org/10.1177/14791641211043598
Lin J, Zhang Y, Wang H, Li X. Inflammatory markers and glycemic control in patients with type 2 diabetes: A population-based study. J Inflamm Res. 2022;15:4125–4135. https://doi.org/10.2147/JIR.S373237
Nakamura H, Sato T, Yamashita T, et al. Association of physical inactivity with systemic inflammation and metabolic control in T2DM patients. J Diabetes Res Clin Pract. 2023;195:110217.
Rahman MA, Akhter S, Khan SA, et al. Influence of smoking and dietary habits on CRP levels in individuals with type 2 diabetes: A population-based study. Diabetes Inflamm Rev. 2021;6(2):89–97.
Smith J, Patel R. CRP and cardiovascular risk prediction in diabetes: revisiting clinical guidelines. Eur Heart J. 2022;43(4):332–339.
Wang Y, Liu L, Zhang Y. The prognostic value of high-sensitivity C-reactive protein in patients with type 2 diabetes and cardiovascular events: A cohort study. BMC Cardiovasc Disord. 2020;20:220. https://doi.org/10.1186/s12872-020-01491-3
Zhang T, Li Y. C-reactive protein and its role in metabolic syndrome: Pathophysiological links and clinical implications. Metabolism Open. 2023;18:100187. https://doi.org/10.1016/j.metop.2023.100187
Zhao L, Liu Q, Zhang W, Li H. C-reactive protein and HbA1c: Inflammatory mechanisms and clinical significance in type 2 diabetes. Front Endocrinol. 2021;12:654123. https://doi.org/10.3389/fendo.2021.654123
Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2022;18(2):88–98. https://doi.org/10.1038/s41574-021-00539-1
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