High-sensitivity C-reactive protein: a novel cardiovascular risk predictor in type 2 diabetics with normal lipid profile

Background: India is the diabetic capital of the world. Coronary heart disease is a major cause of morbidity and mortality among diabetics. Type 2 diabetes mellitus and atherosclerosis are complex diseases sharing common antecedents like inflammation. High-sensitivity C-reactive protein (hs-CRP), an acute phase reactant protein, is a proinflammatory atherogenic circulating marker which can prove to be an independent cardiac risk predictor. Aim: The aim of the present study was to evaluate the role of hs-CRP as an independent cardiovascular risk marker among Indians with type 2 diabetes with normal lipid profile. Settings and Design: This was a case control study including 60 type 2 diabetics with normal lipid profile and 60 age- and sex-matched healthy controls. Materials and Methods: Twelve-hour fasting blood samples were collected from all the participants. Serum was assayed for hs-CRP and lipid profile. Statistical Analysis: Results were analyzed by unpaired t test. Results: We found elevated hs-CRP levels (4.8 +/- 0.2, P<.0001) among cases compared to controls (0.9 +/- 0.1). According to hs-CRP levels, seven cases were in the low-risk (<1 mg/l), 32 in the moderate-risk (1-3 mg/l), and 21 in the high-risk (3-10 mg/l) group with mean values of hs-CRP of 0.7 +/- 0.2, 1.75 +/- 0.7, and 5.8 +/- 1.4, respectively. Relative risk was 4.75 with odds ratio of 10.23 (95% confidence interval 8.8-11.23). Conclusion: The study suggests that hs-CRP is an independent cardiac risk predictor even with normal lipid profile and can help measure additional risk. The American Heart Association stated that patients in the intermediate- and high-risk group may benefit from therapeutic lifestyle change and that cardiovascular event may be prevented. (C) 2011 Elsevier Inc. All rights reserved.