Endocrine Abstracts

Introduction: RaisedCRP is observed in obesity, metabolic syndrome and type 2 diabetes in the absence of any inflammatory or infectious disease. Indeed, it may constitute a mark of cardiovascular risk and macro and micro-vascular complications. The objective of our study is to assess the association between raised ultra-sensitive CRP and macro-vascular and micro-vascular complications in a group ofpatients with type 2 diabetes (T2DM).

Materials and methods: A comparative retrospective observational study including 176 patients with T2DM followed in department C of the NationalNutrition Institute of Tunis. Clinical and biological data were collected from medical records. Patients were classified into two groups according to the level of ultra-sensitive CRP (Group 1: low CRP < 3 mg/l and group 2: high CRP ≥ 3 mg/l).

Results: The mean age was 58.8 ± 12 years. A female predominance was noted (62%). The mean duration of diabetes was 12 ± 7.7 years. The average BMI was 28.9 ± 5.4 kg/m². The average HBA1c was 10.5 ± 2.3%. Half of the patients were on insulin (49.2%). The mean CRP was 5.1 ± 4.3 mg/l with no significant difference between the two sexes. Two-thirds of women (71.6%) and 38% of men had high CRP (P = 0.02). Patients with elevated CRP were on insulin and had higher BMI and uric acid levels (P = 0.008, P = 0.037 and P = 0.04 respectively). Macro and micro-vascular complications were noted in 23.3% and 52.2%, 38.8% and 57.7%, 13.8% and 53.2%, in the whole population, in male patients and female patients respectively. Depending on gender, there was not a significant difference regarding macrovascular complications (coronary artery disease, stroke and peripheral artery disease) between patients with normal or elevated CRP. In contrast, in men the prevalence of micro-angiopathy, represented by diabetic nephropathy (27%) and diabetic retinopathy (47.5%), was higher in patients with elevated CRP (P = 0.02).

Conclusion: Our study found that women with type 2 diabetes had higher CRP levels. In contrast, raised CRP was associated with a higher risk of microvascular complications, mainly diabetic retinopathy and nephropathy, in men with type 2 diabetes.