C-Reactive protein in type 1 diabetes and its relationship to coronary artery calcification

Helen M. Colhoun, Casper Schalkwijk, Michael B. Rubens, Coen D.A. Stehouwer

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    Abstract

    OBJECTIVE—In 196 type 1 diabetic subjects and 195 nondiabetic subjects aged 30–55 years, we examined whether C-reactive protein (CRP) is elevated in diabetes and whether CRP is associated with coronary artery calcification (CAC). RESEARCH DESIGN AND METHODS—CRP was measured with a highly sensitive immunoassay. CAC was measured using electron beam computed tomography. RESULTS—CRP was elevated in diabetic women compared with nondiabetic women (median 1.62 vs. 0.85 mg/l, P < 0.001) independently of other factors, but was similar in diabetic and nondiabetic men (median 0.82 vs. 0.81 mg/l). Insulin dose per day was positively correlated with CRP in diabetic women (Spearman’s ? = 0.36, P = 0.0003) but much less so in men (? = 0.16, P = 0.09). Being in the top tertile for CRP was associated with CAC in diabetic and nondiabetic men even after adjustment for other risk factors (adjusted odds ratio [OR] = 4.6 and 4.3, respectively, P = 0.02 for both). In nondiabetic women, being in the top tertile for CRP was associated with CAC (OR 3.1, P = 0.04), but not independently of BMI (OR = 1 after adjustment). Among diabetic women the association was not significant even before adjustment for BMI (OR = 2.6, P = 0.07). CONCLUSIONS—Elevated CRP in diabetic women might reflect a particular sensitivity to insulin levels or might reflect insulin resistance. In general, CRP is an important marker of subclinical atherosclerosis, but the clinical significance of elevated CRP in diabetic women needs to be addressed in prospective studies, since CRP was not clearly associated with CAC in this group.
    Original languageEnglish
    Pages (from-to)1813-1817
    Number of pages5
    JournalDiabetes Care
    Volume25
    Issue number10
    DOIs
    Publication statusPublished - Oct 2002

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    Type 1 Diabetes Mellitus
    C-Reactive Protein
    Coronary Vessels
    Odds Ratio
    Insulin Resistance
    X Ray Computed Tomography
    Immunoassay
    Atherosclerosis
    Research Design
    Prospective Studies
    Insulin

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    Colhoun, H. M., Schalkwijk, C., Rubens, M. B., & Stehouwer, C. D. A. (2002). C-Reactive protein in type 1 diabetes and its relationship to coronary artery calcification. Diabetes Care, 25(10), 1813-1817. https://doi.org/10.2337/diacare.25.10.1813
    Colhoun, Helen M. ; Schalkwijk, Casper ; Rubens, Michael B. ; Stehouwer, Coen D.A. / C-Reactive protein in type 1 diabetes and its relationship to coronary artery calcification. In: Diabetes Care. 2002 ; Vol. 25, No. 10. pp. 1813-1817.
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    abstract = "OBJECTIVE—In 196 type 1 diabetic subjects and 195 nondiabetic subjects aged 30–55 years, we examined whether C-reactive protein (CRP) is elevated in diabetes and whether CRP is associated with coronary artery calcification (CAC). RESEARCH DESIGN AND METHODS—CRP was measured with a highly sensitive immunoassay. CAC was measured using electron beam computed tomography. RESULTS—CRP was elevated in diabetic women compared with nondiabetic women (median 1.62 vs. 0.85 mg/l, P < 0.001) independently of other factors, but was similar in diabetic and nondiabetic men (median 0.82 vs. 0.81 mg/l). Insulin dose per day was positively correlated with CRP in diabetic women (Spearman’s ? = 0.36, P = 0.0003) but much less so in men (? = 0.16, P = 0.09). Being in the top tertile for CRP was associated with CAC in diabetic and nondiabetic men even after adjustment for other risk factors (adjusted odds ratio [OR] = 4.6 and 4.3, respectively, P = 0.02 for both). In nondiabetic women, being in the top tertile for CRP was associated with CAC (OR 3.1, P = 0.04), but not independently of BMI (OR = 1 after adjustment). Among diabetic women the association was not significant even before adjustment for BMI (OR = 2.6, P = 0.07). CONCLUSIONS—Elevated CRP in diabetic women might reflect a particular sensitivity to insulin levels or might reflect insulin resistance. In general, CRP is an important marker of subclinical atherosclerosis, but the clinical significance of elevated CRP in diabetic women needs to be addressed in prospective studies, since CRP was not clearly associated with CAC in this group.",
    author = "Colhoun, {Helen M.} and Casper Schalkwijk and Rubens, {Michael B.} and Stehouwer, {Coen D.A.}",
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    Colhoun, HM, Schalkwijk, C, Rubens, MB & Stehouwer, CDA 2002, 'C-Reactive protein in type 1 diabetes and its relationship to coronary artery calcification', Diabetes Care, vol. 25, no. 10, pp. 1813-1817. https://doi.org/10.2337/diacare.25.10.1813

    C-Reactive protein in type 1 diabetes and its relationship to coronary artery calcification. / Colhoun, Helen M.; Schalkwijk, Casper; Rubens, Michael B.; Stehouwer, Coen D.A.

    In: Diabetes Care, Vol. 25, No. 10, 10.2002, p. 1813-1817.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - C-Reactive protein in type 1 diabetes and its relationship to coronary artery calcification

    AU - Colhoun, Helen M.

    AU - Schalkwijk, Casper

    AU - Rubens, Michael B.

    AU - Stehouwer, Coen D.A.

    N1 - dc.publisher: American Diabetes Association dc.description.sponsorship: British Heart Foundation

    PY - 2002/10

    Y1 - 2002/10

    N2 - OBJECTIVE—In 196 type 1 diabetic subjects and 195 nondiabetic subjects aged 30–55 years, we examined whether C-reactive protein (CRP) is elevated in diabetes and whether CRP is associated with coronary artery calcification (CAC). RESEARCH DESIGN AND METHODS—CRP was measured with a highly sensitive immunoassay. CAC was measured using electron beam computed tomography. RESULTS—CRP was elevated in diabetic women compared with nondiabetic women (median 1.62 vs. 0.85 mg/l, P < 0.001) independently of other factors, but was similar in diabetic and nondiabetic men (median 0.82 vs. 0.81 mg/l). Insulin dose per day was positively correlated with CRP in diabetic women (Spearman’s ? = 0.36, P = 0.0003) but much less so in men (? = 0.16, P = 0.09). Being in the top tertile for CRP was associated with CAC in diabetic and nondiabetic men even after adjustment for other risk factors (adjusted odds ratio [OR] = 4.6 and 4.3, respectively, P = 0.02 for both). In nondiabetic women, being in the top tertile for CRP was associated with CAC (OR 3.1, P = 0.04), but not independently of BMI (OR = 1 after adjustment). Among diabetic women the association was not significant even before adjustment for BMI (OR = 2.6, P = 0.07). CONCLUSIONS—Elevated CRP in diabetic women might reflect a particular sensitivity to insulin levels or might reflect insulin resistance. In general, CRP is an important marker of subclinical atherosclerosis, but the clinical significance of elevated CRP in diabetic women needs to be addressed in prospective studies, since CRP was not clearly associated with CAC in this group.

    AB - OBJECTIVE—In 196 type 1 diabetic subjects and 195 nondiabetic subjects aged 30–55 years, we examined whether C-reactive protein (CRP) is elevated in diabetes and whether CRP is associated with coronary artery calcification (CAC). RESEARCH DESIGN AND METHODS—CRP was measured with a highly sensitive immunoassay. CAC was measured using electron beam computed tomography. RESULTS—CRP was elevated in diabetic women compared with nondiabetic women (median 1.62 vs. 0.85 mg/l, P < 0.001) independently of other factors, but was similar in diabetic and nondiabetic men (median 0.82 vs. 0.81 mg/l). Insulin dose per day was positively correlated with CRP in diabetic women (Spearman’s ? = 0.36, P = 0.0003) but much less so in men (? = 0.16, P = 0.09). Being in the top tertile for CRP was associated with CAC in diabetic and nondiabetic men even after adjustment for other risk factors (adjusted odds ratio [OR] = 4.6 and 4.3, respectively, P = 0.02 for both). In nondiabetic women, being in the top tertile for CRP was associated with CAC (OR 3.1, P = 0.04), but not independently of BMI (OR = 1 after adjustment). Among diabetic women the association was not significant even before adjustment for BMI (OR = 2.6, P = 0.07). CONCLUSIONS—Elevated CRP in diabetic women might reflect a particular sensitivity to insulin levels or might reflect insulin resistance. In general, CRP is an important marker of subclinical atherosclerosis, but the clinical significance of elevated CRP in diabetic women needs to be addressed in prospective studies, since CRP was not clearly associated with CAC in this group.

    U2 - 10.2337/diacare.25.10.1813

    DO - 10.2337/diacare.25.10.1813

    M3 - Article

    VL - 25

    SP - 1813

    EP - 1817

    JO - Diabetes Care

    JF - Diabetes Care

    SN - 0149-5992

    IS - 10

    ER -