Elevated C-Reactive Protein Associates With Early-Stage Carotid Atherosclerosis in Young Subjects With Type 1 Diabetes

Elevated C-Reactive Protein Associates With Early-Stage Carotid Atherosclerosis in Young Subjects With Type 1 Diabetes Rieko Hayaishi-Okano , MD 1 , Yoshimitsu Yamasaki , MD, PHD 1 , Naoto Katakami , MD 1 , Kentaro Ohtoshi , MD 1 , Shin-Ichi Gorogawa , MD 1 , Akio Kuroda , MD 1 , Munehide Matsuhisa , MD, PHD 1 , Keisuke Kosugi , MD, PHD 2 , Norikiyo Nishikawa , MD, PHD 2 , Yoshitaka Kajimoto , MD, PHD 1 and Masatsugu Hori , MD, PHD 1 1 Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan 2 Osaka Police Hospital, Osaka, Japan Abstract OBJECTIVE —To evaluate whether low-grade inflammation contributes to early-stage advanced carotid atherosclerosis in young subjects with type 1 diabetes. RESEARCH DESIGN AND METHODS —The mean and maximum (max) intima-media thicknesses (IMT) of the carotid artery were assessed using ultrasound B-mode imaging in 55 patients with type 1 diabetes (22 men and 33 women, aged 22.1 ± 3.6 years (± SD), duration of diabetes 14.2 ± 5.7 years) and 75 age-matched healthy nondiabetic subjects (28 men and 47 women). High-sensitive C-reactive protein (hs-CRP) levels were measured with a latex-enhanced immunonephelometer. RESULTS —The patients with type 1 diabetes had significantly higher hs-CRP levels (median 0.35, range 0.05–1.47 mg/l vs. median 0.14, range 0.05–1.44 mg/l; P = 0.001) as well as significantly higher mean IMT and max IMT than the nondiabetic subjects (mean IMT 0.76 ± 0.09 vs. 0.72 ± 0.04 mm, P = 0.003; max IMT 0.84 ± 0.11 vs. 0.77 ± 0.06 mm, P < 0.0001). Hs-CRP levels were significantly correlated with the mean and max IMT of patients with type 1 diabetes and with the max IMT of nondiabetic patients. Multivariate regression analyses for both diabetic and nondiabetic subjects as a single group showed that hs-CRP levels are independently correlated with the mean IMT and max IMT levels ( P = 0.002 and P = 0.023, respectively) as well as with diastolic blood pressure, sex, and duration of diabetes. CONCLUSIONS —Our data indicate that hs-CRP levels are elevated in young patients with type 1 diabetes, possibly corresponding with early-stage advanced carotid atherosclerosis. AER, albumin excretion rate CVD, cardiovascular disease hs-CRP, high-sensitive C-reactive protein IMT, intima-media thickness LDL-c, LDL cholesterol max, maximum Footnotes Address correspondence and reprint requests to Yoshimitsu Yamasaki, MD, PhD, Department of Internal Medicine and Therapeutics, Osaka Univ