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Nephropathy in type 2 diabetes increased along with serum C-reactive protein levels
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Serum high-sensitivity C-reactive protein was associated with the development, but not progression, of nephropathy in patients with type 2 diabetes, according to research published in Diabetes Care.
Measuring serum high-sensitivity C-reactive protein (hs-CRP) levels could predict future risk for the kidney complication, but treatment approaches warrant further investigation, according to Japanese researchers.
“More research is needed to examine if there is an effective strategy to reduce the risk of diabetic nephropathy in a group of patients with diabetes and elevated levels of hs-CRP,” the researchers wrote.
Yasuaki Hayashino, MD, of Tenri Hospital in Nara, Japan, and colleagues used longitudinal data from 2,518 patients (mean age, 66.1 years; BMI, 24.6 kg⁄m2; HbA1c, 7.5%, 57.6 mmol/mol) with type 2 diabetes obtained from a national diabetes registry.
Patients were divided into quartiles based on serum hs-CRP levels. The researchers used Cox proportional hazards to assess independent correlations between serum baseline hs-CRP and either the development or progression of diabetic nephropathy at 1 year; adjustments were made for potential confounders.
At baseline, serum hs-CRP levels were significantly associated with the urinary albumin-to-creatinine ratio (P<.001). A statistically significant linear trend was observed across quartiles (P<.001), with multivariable adjusted HR for the development from normoalbuminuria to microalbuminuria at 1.31 (95% CI, 0.8-2.17) in the second quartile, then increasing to 1.55 (95% CI, 1.16-2.08) in the third quartile and 1.57 (95% CI, 1.22-2.03) in the fourth quartile.
No significant association was seen between hs-CRP levels and subsequent risk for diabetic nephropathy progression (P for trend=.575).
Disclosure: This study was partially supported by the Manpei Suzuki Diabetes Foundation and JSPS KAKENHI.
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