Determinants of raised C-reactive protein concentration in type 1 diabetes

As a marker of systemic inflammation, raised C-reactive protein (CRP) conce ntrations which are still within the normal range have been associated with an increased incidence of coronary heart disease (CHD) in non-diabetic sub jects. This study aimed to establish potential determinants of raised CRP c oncentrations in type 1 diabetic patients. We used a sensitive assay to mea sure 'low-level' CRP concentrations in 167 type 1 patients (93M, 74F, media n age 30 years, range 13-67). Stepwise multivariate analysis was used to re late these CRP levels to known cardiovascular risk factors and demographic data. Only six patients had established CHD (median CRP 3.34 mg/l vs. 0.83 mg/l, p = 0.032). In subjects without overt CHD, multivariate analysis show ed increases in subject age (p = 0.0025), BMI (p = 0.001) and HbA, (p = 0.0 12) to be associated with a higher CRP concentration, as was female sex (p = 0.026) and a history of CHD in a first-degree relative (p = 0.018, n = 57 ). The duration of diabetes, current smoking status, presence of microvascu lar complications, lipid status and presence of hypertension were unrelated . This study suggests that some of the risk factors associated with CHD in type 1 patients are also independently predictive of high CRP concentration s. The reasons for this, and whether intervention would prove useful, requi re further investigation.