ASSESSMENT OF C-REACTIVE PROTEINS IN RECENTLY DIAGNOSED TYPE-1 DIABETIC CHILDREN AS A RISK MARKER OF EARLY ATHEROSCLEROSIS
AbstractBackground: Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in diabetes mellitus (DM). Studies indicate that atherosclerosis has slowly altered from a model of chronic degenerative disease affecting patients with advanced ages to a model of subclinical chronic inflammatory disease present in childhood. DM is a risk factor for atherosclerosis and asymptomatic low grade inflammation occurs prior to unconcealed vascular lesions in these patients. A low grade inflammation can be determined by serum C-reactive protein (CRP). The aim of this study was to evaluate serum CRP levels in recently diagnosed type-1 diabetic children to predict early cardiovascular complications. Methods: In this cross-sectional study, serum CRP levels were determined in 39 diabetic children and 40 healthy children as control. CRP concentrations were determined by ELISA by an automated ELISA analyzer. The values were expressed as mean±standard deviation and data from patients and controls was compared by t-test. Results: Serum CRP levels were significantly elevated in diabetic children as compared to controls (p<0.001). Conclusion: Serum CRP can be used as a potent biochemical markers in addition to other traditional risk factors like dyslipidemia, hypertension, obesity and smoking to detect high risk patients. Keywords: CRP, type-1 diabetes, cardiovascular disease, inflammatory markers.
Folsom AR, Pankow JS, Tracy RP, Arnett DK, Peacock JM, Hong Y, et al. Association of C-reactive protein with markers of prevalent atherosclerotic disease. Am J Cardiol 2001;88:112–7.
Ridker PM. High-sensitivity C- reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001;103:1813–8.
Ridker PM. Role of inflammatory biomarkers in prediction of coronary heart disease. Lancet 2001;358:946–8
Picardi A, Valorani MG, Vespasiani GU, Manfrini S, Ciofini O, Cappa M, et al.. Raised C-reactive protein levels in patients with recent onset type-1 diabetes. Diabetes Metab Res Rev 2007;23:211–4.
Koenig W. Predicting risk and treatment benefit in atherosclerosis. Int J Cardiol 2005;98:199–206.
Hayaishi-Okano R, Yamasaki Y, Katakami N, Ohtoshi K, Gorogawa S, Kuroda A, et al. Elevated C-reactive protein associates with early-stage carotid atherosclerosis in young subjects with type-1 diabetes. Diabetes Care 2002;25:1432–8.
Haverkate F, Thompson SG, Pyke SD, Gallimore JR, Pepys MB. Production of C-reactive protein and risk of coronary events in stable and unstable angina. Lancet 1997;349:462–6.
Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation ,aspirin and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997;336:973–9.
Cao JJ, Thach C, Manolio TA, Psaty BM, Kuller LH, Chaves PH, et al. C-reactive protein, carotid intima-media thickness and incidence of ischemic stroke in the elderly. Circulation 2005;108(2):166–70.
Tracy RP, Psaty BM, Macy EM, Bovill EG, Cushman M, Cornell ES, et al. lifetime smoking exposure affects the association of C-reactive protein with cardiovascular disease risk factors and subclinical disease in healthy elderly subjects. Arterioscler Thromb Vasc Biol 1997;17:2167–76.
Lombardo A, Biasucci LM, Lanza GA, Coli S, Silvestri P, Cianflone D, et al. inflammation as a possible link between coronary and carotid plaque instability. Circulation 2004;109:3158–63.
Avanzas P, Arroyo-Espliguero R, Cosin-Sales J, Quiles J, Zouridakis E, Kaski JC. Multiple complex stenoses. High neutrophils count and C-reactive levels in patients with chronic stable angina. Atherosclerosis 2004;175:151–7.
Pearson TA, Mensah GA, Alexander RW. Marker of inflammation and cardiovascular disease. Application to clinical and public health practice. Circulation 2003;107:499–511.
Pepy MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003;11:1805–12.
Okano RH, Yamasaki Y, Katakami N, Ohtoshi K, Gorogawa S, Kuroda A, et al. Elevated C-reactive protein associates with early stage carotid atherosclerosis in young subjects with type-1 diabetes. Diabetes Care 2002;25:1432–8.
Tan KC, Chow WS, Tam SC, Ai VH, Lam CH, Lam KS. Atrovastatin lowers C-reactive protein and improves endothelium-dependent vasodilation in type-2 diabetes mellitus. J Clin Endocrinol Metab 2002;87:563–8.
Pasceri V, Willerson JT, Yeh ET. Direct pro-inflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000;102:2165–8.
Cook DG, Mendall MA, Whincup PH. C-reactive protein concentration in children: relationship to adiposity and other cardiovascular risk factors. Atherosclerosis 2000;149(1):139–50.