Clinical and nutritional correlates of C-reactive protein in type 2 diabetic nephropathy

• Published in: Atherosclerosis Vol. 172; no. 1; pp. 121 - 125
• Main Authors: Friedman, Allon N., Hunsicker, Lawrence G., Selhub, Jacob, Bostom, Andrew G.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 2004; Elsevier
• Subjects: Adult; Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Body Mass Index; C-reactive protein; C-Reactive Protein - analysis; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - etiology; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Creatinine; Creatinine - blood; Depsipeptides; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - metabolism; Diabetic Nephropathies - complications; Diabetic Nephropathies - metabolism; Female; Folic Acid - blood; Glycated Hemoglobin A - analogs & derivatives; Glycated Hemoglobin A - analysis; Humans; Male; Medical sciences; Middle Aged; Peptides, Cyclic - blood; Proteinuria; Pyridoxal phosphate; Pyridoxal Phosphate - blood; Risk Factors; Serum Albumin - analysis; Triglycerides - blood; Vitamin B 12 - blood; Vitamin B 6; Pyridoxal phosphate; Creatinine; Body mass index; Vitamin B 6; C-reactive protein; Cardiovascular; Diabetes; Type 2 diabetes; Systolic pressure; Vitamin; Lipids; Cardiovascular disease; Folate; Vascular disease; Homocystein; Triacylglycerol; Atherosclerosis; Hemoglobin; C reactive protein; Kidney disease; Human; Urinary system disease; Albumin; Cholesterol; Nephropathy; Irbesartan; Risk factor; Vitamin B6
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2003.09.011

Background: Patients with diabetic nephropathy are at elevated cardiovascular risk. C-reactive protein (CRP) has been used to successfully predict cardiovascular events. Objective: We identified clinical and biochemical characteristics that correlate with CRP levels in diabetic nephropathy patients. Design: Baseline data obtained from 722 patients in the Irbesartan Diabetic Nephropathy Trial included age, sex, body mass index (BMI), systolic blood pressure (BP), serum creatinine, plasma low- and high-density cholesterol, triacylglycerol, serum albumin, hemoglobin A1C, 24 h urinary protein excretion, plasma total homocysteine (tHcy), folate, B12, pyridoxal 5′-phosphate (PLP, active form of Vitamin B 6), and plasma CRP levels. Results: In univariate analyses CRP was positively associated with female sex ( r=0.08; P=0.04), BMI ( r=0.34; P<0.01), serum creatinine ( r=0.21; P<0.01), hemoglobin A1C ( r=0.08; 0.04), and inversely associated with PLP ( r=−0.17; P<0.01) and folate ( r=−0.09; P=0.02). A stepwise multiple regression model found CRP directly correlated with BMI ( P<0.01) and serum creatinine ( P<0.01), and inversely correlated with PLP ( P<0.01). The final model explained 16% of the total variance of CRP. Conclusions: These results extend previous findings of an inverse relationship between Vitamin B 6 and CRP. The lack of association between CRP and certain established or emerging cardiovascular risk factors offers novel information regarding cardiovascular risk in this population.