title: Initiation of insulin therapy reduces serum concentrations of high-sensitivity C-reactive protein in patients with type 2 diabetes.
abstract: Atherosclerosis has highly important chronic inflammatory aspects. We investigated anti-inflammatory effects upon initiating insulin therapy by measuring serum high-sensitivity C-reactive protein (hsCRP) and plasma fibrinogen and serum monocyte chemoattractant protein (MCP)-1in patients with poorly controlled type 2 diabetes. In 18 inpatients with type 2 diabetes, we measured serum hsCRP, plasma fibrinogen, serum MCP-1, body weight (BW), girth, and fasting plasma glucose (FPG) before and 2 weeks (14.0 +/- 2.5 days) after initiation of insulin therapy. Daily insulin doses (in units) were approximately 0.2 x BW (in kilograms). Various changes (ratio) were calculated as the ratio of the value during treatment to the pretreatment value. Significant decreases occurred for log(10) hsCRP and FPG (-0.025 +/- 0.557 mg/L, 215 +/- 64.3 mg/dL v -0.213 +/- 0.571 mg/L, 129.8 +/- 32.1 mg/dL; P =.0121, and P =.00002, respectively). This was particularly true for log(10) hsCRP in patients whose BW was unchanged or increased between measurement (P =.0050). There were no significant differences between pretreatment and treatment values for fibrinogen and MCP-1. However, MCP-1 decreased significantly in the group with high-value in the first time point (MCP-1 > 250 pg/mL, n = 9; P =.0224) compared with the low-value group (MCP-1 < 250 pg/mL, n = 9; P =.3164). No significant correlation was found between hsCRP ratio and fibrinogen ratio, MCP-1 ratio, BW ratio, waist girth ratio, or FPG ratio. In conclusion, newly initiated insulin therapy in patients with poorly controlled type 2 diabetes decreased serum hsCRP. The decrease in hsCRP may have resulted largely from anti-inflammatory effects of insulin.
authors.affiliation: Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Japan.
authors.forename: Kohzo
authors.initials: K
authors.lastname: Takebayashi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Aso
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Inukai
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D001824:Body Constitution; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism*; D018932:Chemokine CCL2 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005215:Fasting / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007279:Injections, Subcutaneous; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012907:Smoking / Q000097:blood; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001786:Blood Glucose; D018932:Chemokine CCL2; D007328:Insulin; D005340:Fibrinogen; D002097:C-Reactive Protein