Diabetologia

, Volume 42, Issue 3, pp 351–357

Plasma concentration of C-reactive protein is increased in Type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: evidence for chronic inflammation

  • C. G. Schalkwijk
  • D. C. W. Poland
  • W. van Dijk
  • A. Kok
  • J. J. Emeis
  • A. M. Dräger
  • A. Doni
  • V. W. M. van Hinsbergh
  • C. D. A. Stehouwer
Short communication

DOI: 10.1007/s001250051162

Cite this article as:
Schalkwijk, C., Poland, D., van Dijk, W. et al. Diabetologia (1999) 42: 351. doi:10.1007/s001250051162

Summary

Moderately increased plasma concentrations of C-reactive protein are associated with an increased risk of cardiovascular disease. C-reactive protein, its relation to a low degree of inflammatory activation and its association with activation of the endothelium have not been systematically investigated in Type I (insulin-dependent) diabetes mellitus. C-reactive protein concentrations were measured in 40 non-smoking patients with Type I diabetes without symptoms of macrovascular disease and in healthy control subjects, and in a second group of Type I diabetic patients (n = 60) with normo- (n = 20), micro- (n = 20) or macroalbuminuria (n = 20). Differences in glycosylation of α1-acid glycoprotein were assayed by crossed affinity immunoelectrophoresis. Activation of the endothelium was measured with plasma concentrations of endothelial cell markers. The median plasma concentration of C-reactive protein was higher in Type I diabetic patients compared with healthy control subjects [1.20 (0.06–21.64) vs 0.51 (0.04–9.44) mg/l; p < 0.02]. The Type I diabetic subjects had a significantly increased relative amount of fucosylated α1-acid glycoprotein (79 ± 12 % vs 69 ± 14 % in the healthy control subjects; p < 0.005), indicating a chronic hepatic inflammatory response. In the Type I diabetic group, log(C-reactive protein) correlated significantly with von Willebrand factor (r = 0.439, p < 0.005) and vascular cell adhesion molecule-1 (r = 0.384, p < 0.02), but not with sE-selectin (r = 0.008, p = 0.96). In the second group of Type I diabetic patients, increased urinary albumin excretion was associated with a significant increase of von Willebrand factor (p < 0.0005) and C-reactive protein (p = 0.003), which were strongly correlated (r = 0.53, p < 0.0005). Plasma concentrations of C-reactive protein were higher in Type I diabetic patients without (clinical) macroangiopathy than in control subjects, probably due to a chronic hepatic inflammatory response. The correlation of C-reactive protein with markers of endothelial dysfunction suggests a relation between activation of the endothelium and chronic inflammation. [Diabetologia (1999) 42: 351–357]

Keywords Type I (insulin-dependent) diabetes mellitus acute-phase response C-reactive protein atherosclerosis inflammation vascular disease α1-acid glycoprotein fucosylation. 
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© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • C. G. Schalkwijk
    • 1
  • D. C. W. Poland
    • 2
  • W. van Dijk
    • 2
  • A. Kok
    • 1
  • J. J. Emeis
    • 5
  • A. M. Dräger
    • 1
  • A. Doni
    • 4
  • V. W. M. van Hinsbergh
    • 3
  • C. D. A. Stehouwer
    • 1
  1. 1.Department of Clinical Chemistry, Haematology and Internal Medicine, Academic Hospital Vrije Universiteit, Amsterdam, The NetherlandsNL
  2. 2.Department of Medical Chemistry, Institute for Immunology and Inflammatory Diseases, Vrije Universiteit, Amsterdam, The NetherlandsNL
  3. 3.Institute for Cardiovascular Research, Vrije Universiteit, Amsterdam, The NetherlandsNL
  4. 4.Istituto di Ricerche Farmacologiche ’Mario Negri', Milan, ItalyIT
  5. 5.Gaubius Laboratory TNO-PG, Leiden, The NetherlandsNL

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