Clinical and nutritional correlates of C-reactive protein in type 2 diabetic nephropathy.
BACKGROUND
Patients with diabetic nephropathy are at elevated cardiovascular risk. C-reactive protein (CRP) has been used to successfully predict cardiovascular events.


OBJECTIVE
We identified clinical and biochemical characteristics that correlate with CRP levels in diabetic nephropathy patients.


METHODS
Baseline data obtained from 722 patients in the Irbesartan Diabetic Nephropathy Trial included age, sex, body mass index (BMI), systolic blood pressure (BP), serum creatinine, plasma low- and high-density cholesterol, triacylglycerol, serum albumin, hemoglobin A1C, 24h urinary protein excretion, plasma total homocysteine (tHcy), folate, B12, pyridoxal 5'-phosphate (PLP, active form of Vitamin B(6)), and plasma CRP levels.


RESULTS
In univariate analyses CRP was positively associated with female sex (r=0.08; P=0.04), BMI (r=0.34; P<0.01), serum creatinine (r=0.21; P<0.01), hemoglobin A1C (r=0.08; 0.04), and inversely associated with PLP (r=-0.17; P<0.01) and folate (r=-0.09; P=0.02). A stepwise multiple regression model found CRP directly correlated with BMI (P<0.01) and serum creatinine (P<0.01), and inversely correlated with PLP (P<0.01). The final model explained 16% of the total variance of CRP.


CONCLUSIONS
These results extend previous findings of an inverse relationship between Vitamin B(6) and CRP. The lack of association between CRP and certain established or emerging cardiovascular risk factors offers novel information regarding cardiovascular risk in this population.
Friedman
Allon N
AN
Division of Nephrology, Indiana University School of Medicine, 1481 W. 10th St.-111N, Indianapolis, IN 46202, USA. allfried@iupui.edu
Hunsicker
Lawrence G
LG
Selhub
Jacob
J
Bostom
Andrew G
AG
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D047630:Depsipeptides; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000150:complications* / Q000378:metabolism; D005260:Female; D005492:Folic Acid / Q000097:blood; D006442:Glycated Hemoglobin / Q000031:analogs & derivatives* / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000097:blood; D011507:Proteinuria; D011732:Pyridoxal Phosphate / Q000097:blood; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D014280:Triglycerides / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood
D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003404:Creatinine; D047630:Depsipeptides; D005492:Folic Acid; D006442:Glycated Hemoglobin; D010456:Peptides, Cyclic; D011732:Pyridoxal Phosphate; D012709:Serum Albumin; D014280:Triglycerides; D014805:Vitamin B 12; C025617:glucosylated hemoglobin A; C086296:homodestruxin B