Elevated C-Reactive Protein Levels in the Development of Type 1 Diabetes

Elevated C-Reactive Protein Levels in the Development of Type 1 Diabetes H. Peter Chase 1 , Sonia Cooper 1 , Iris Osberg 2 , Lars C. Stene 1 , Katherine Barriga 3 , Jill Norris 3 , George S. Eisenbarth 1 and Marian Rewers 1 3 1 Department of Pediatrics, The Barbara Davis Center for Childhood Diabetes, Denver, Colorado 2 General Clinical Research Center Laboratory, University of Colorado Health Sciences Center, Denver, Colorado 3 Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado Address correspondence and reprint requests to H. Peter Chase, MD, 4200 E. 9th Ave., B140, Denver, CO 80262. E-mail: peter.chase{at}uchsc.edu Abstract Elevated C-reactive protein (CRP) levels have previously been described before the onset of type 2 diabetes and gestational diabetes. We hypothesized that inflammation, as reflected by elevated CRP levels, can help predict development of islet autoimmunity or type 1 diabetes. Children at risk for type 1 diabetes and followed in the Diabetes Autoimmunity Study of the Young (DAISY) had blood samples drawn and frozen serum saved at various intervals after birth. CRP was measured using a high-sensitivity sandwich enzyme immunoassay. Islet autoantibodies (IAs) were measured using biochemical immunoassays. Elevations in CRP concentrations were significantly more frequent ( P < 0.01) in children who later developed type 1 diabetes (8 of 16 children) than in children negative for IAs at their last testing (3 of 26). Children with one or more positive IA were more likely to have elevated CRP concentrations (15 of 36) than IA-negative children (3 of 26; P < 0.01). The finding of elevated CRP levels in infants and young children before the onset of type 1 diabetes adds to the evidence that the disease is an immunoinflammatory disorder. The elevated CRP levels may provide an additional marker for risk of progression to type 1 diabetes. COX2, cyclooxygenase 2 CRP, C-reactive protein DAISY, Diabetes Autoimmunity Study of the Young IA, islet autoantibody IL, interleukin Footnotes L.C.S. is currently affiliated with the Norwegian Institute of Public Health, Division of Epidemiology, Oslo, Norway. Accepted July 13, 2004. Received October 22, 2003. DIABETES