Association of High Sensitivity C-reactive protein (hs-CRP) Levels with Microalbuminuria in Type 2 Diabetic Patients.

Abstract

High sensitivity C-reactive protein (hs-CRP) is a well-characterized marker of low grade systemic inflammation. Microalbuminuria is an established marker of vascular endothelial damage. There are evidences that nephropathy in type 2 diabetics develops due to sustained chronic low grade inflammation and vascular endothelial dysfunction. The objective of the study was to find out the association of serum high sensitivity C-reactive protein (hs-CRP) levels with microalbuminuria in type 2 diabetic patients. This cross-sectional observational study was carried out in outpatient departments of Nephrology and Endocrinology of Mymensingh Medical College Hospital, Mymensingh. One hundred (100) type 2 diabetic patients in the age group 30 to 70 years with at least one year duration were included in the study. FBS, Serum creatinine, Serum hs-CRP level and Albumin-creatinine ratio (ACR) were measured in these subjects. It was observed that higher level of hs-CRP found in subjects with microalbuminuria. Majority (93.2%) were with microalbuminuria >50mg/gm with hs-CRP >3mg/L. There is statistically significant association between microalbuminuria and hs-CRP (p<0.001). The Pearson correlation test also showed positive correlation between hs-CRP level and microalbuminuria (r=0.876; p<0.001). There were also statistically significant (p<0.05) relationship between microalbuminuria and FBS, HbA1c as well as serum creatinine. This study concludes that microalbuminuria accompanied by elevated hs-CRP in Type 2 diabetic patient suggesting activation of inflammatory pathways. The importance of early detection, monitoring of inflammatory marker hs-CRP and ACR as predictors of diabetic nephropathy can help in modulating diabetes and its complications.