Elevated serum C-reactive protein level and microalbuminuria in patients with type 2 diabetes mellitus

ABSTRACT

Microalbuminuria is a marker of vascular endothelial damage. In addition, it is reported that high serum levels of C-reactive protein [CRP] is a novel cardiovascular risk factor that impairs endothelial function. The aim of this study was to evaluate the relationship between microalbuminuria and elevated serum level of high-sensitivity CRP [HS-CRP] in type 2 diabetic patients. We measured serum levels of HS-CRP in 87 patients with type 2 diabetes mellitus. They were divided into a microalbuminuric group [n = 45] and those with a 24-hour urine albumin less than 30 mg/d [n = 42]. The relationship of serum HS-CRP level with albuminuria and other characteristics of the patients was assessed. Patients with microalbuminuria were significantly older and affected by diabetes mellitus longer than those without microalbuminuria. Also, their mean HS-CRP was significantly higher [4.98 +/- 1.45 mg/L versus 2.82 +/- 2.10 mg/L; P < .001]. The Pearson correlation test showed a significant correlation between HS-CRP level and urine albumin level [r = 0.43; P < .001]. The specificity and sensitivity of HS-CRP for detection of microalbuminuria in were 78.5% and 68.8%, respectively, and the positive and negative predictive values were 77.5% and 70.2%, respectively. In type 2 diabetic patients, microalbuminuria is accompanied by elevated HS-CRP, suggesting activation of inflammatory pathways in progression of renal and cardiovascular atherosclerotic disease. As an easier and cheaper test for assessment of diabetic nephropathy, we recommend further studies on HS-CRP in diabetic patients