Evolution of C-Reactive Protein as a Cardiac Risk Factor

Paula J. D'Amore, PhD, D(ABMLI)

Disclosures

Lab Med. 2005;36(4):234-238. 

In This Article

CRP and Type 2 Diabetes

It has been suggested that low grade inflammation may play a role in the development of type 2 diabetes.[28] Patients with type 2 diabetes had increased levels of hsCRP.[29,30] High hsCRP levels were found to be a independent predictor of risk for the development of type 2 diabetes.[31,32,33] In the Women's Health Study[34] and the West of Scotland Coronary Prevention Study (WOSCOPS),[35] patients with the highest levels of hsCRP were at a much higher risk of developing diabetes. Interleukin-6 was also found to be a predictor of who would develop type 2 diabetes and increasing levels of hsCRP and IL-6 were associated with insulin resistance.[34] Elevated levels of hsCRP and plasminogen-activator inhibitor (PAI) have been demonstrated to predict the incidence of type 2 diabetes in the IRAS.[36] Abdominal obesity and the subsequent secretion of pro-inflammatory cytokines and acute phase reactants may contribute to the relationship between chronic inflammation and type 2 diabetes. Adipocytes (fat cells) are 1 of many cells that secrete IL-6 and the amount of IL-6 produced by adipocytes is proportional to the amount of fat cell mass.[37] Interleukin-6 is the main stimulus for hepatic CRP production, and adipocytes supply approximately 33% of systemic IL-6.[37] Therefore, increased cytokine production by adipocytes in obese people may be the stimulus for increased CRP production. Furthermore, CRP mRNA has been identified in adipose tissue.[38] In support of a connection between obsesity and chronic inflammation, IL-6 and hsCRP levels decreased in obese, post-menopausal women after 6 months of weight loss.[39] Increased glucose utilization and insulin sensitivity were also apparent in these women after the 6 months.

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