Concentration of the complement activation product, acylation-stimulating protein, is related to C-reactive protein in patients with type 2 diabetes

Type 2 diabetes is characterized by increased acute phase serum proteins. W e wanted to study how these proteins are related to complement activation i n type 2 diabetes and how improvement of glycemic control affects them or c omplement activation. A total of 29 type 2 diabetic patients (age, 55.2 +/- 1.8 years, glycosylated hemoglobin [HbA(1c)] 8.9% +/- 0.2%, body mass inde x [BMI] 30.9 +/- 0.8 kg/m(2), duration 5.9 +/- 1.3 years) participated in t he study. They were previously treated either with diet alone or in combina tion with 1 oral antihyperglycemic medication. After a period of at least 4 weeks run-in on diet only, the patients were randomized to pioglitazone, g libenclamide, or placebo. Blood samples were taken before the treatments an d at the end of the g-month therapy. Basal C-reactive protein (CRP) level w as related to acylation-stimulating protein (ASP) concentration (r = .55, P < .01), and many acute phase serum protein concentrations were associated with each other. The treatment reduced HbA(1c) level in the pioglitazone (f rom 9.1 +/- 0.3% to 8.0 +/- 0.5%, P < .05) and glibenclamide (from 8.9% +/- 0.3% to 7.7% +/- 0.2%, P < .05) groups. Glibenclamide treatment was associ ated with a reduction in <alpha>-1-antitrypsin (P < .05), ceruloplasmin (P < .05), and complement C3 protein (C3) (P < .05). Although ASP did not chan ge significantly in any of the treatment subgroups, in the whole patient po pulation, the change in HbA(1c) during the treatments correlated positively with the change in ASP, (r = .43, P < .05). The changes in many acute phas e serum proteins and ASP were related to each other. In conclusion, (1) inf lammatory factors and complement activation are associated in patients with type 2 diabetes, and (2) changes in hyperglycemia are related to changes i n the concentration of the complement activation product, ASP. Copyright (C ) 2001 by W.B. Saunders Company.