title: A single bolus infusion of C-reactive protein increases gluconeogenesis and plasma glucose concentration in humans.
abstract: Recently, we reported that C-reactive protein (CRP) elicits inflammatory and procoagulant responses in humans. In addition, CRP has been associated with the development of type 2 diabetes mellitus. To further explore interactions between CRP and glucose handling, we evaluated the effects of CRP infusion on glucose metabolism in humans. Seven healthy white male volunteers (age, 39.3 +/- 16.9 years) received a single bolus infusion of 1.25 mg/kg purified recombinant human (rh) CRP or CRP-free diluent in a crossover design. C-reactive protein infusion induced an inflammatory response, which was followed by increased plasma concentrations of norepinephrine (3 hours) and cortisol (4 hours). Concomitantly, plasma concentrations of insulin and C-peptide decreased transiently. These metabolic changes increased plasma glucose concentrations from 8 hours after CRP infusion, which was preceded by an increased rate of glucose appearance that was a direct consequence of increased gluconeogenesis. In conclusion, CRP infusion induces an inflammatory response followed by increased norepinephrine and cortisol levels, which results in increased gluconeogenesis. This finding implies that elevated levels of CRP in humans may in fact contribute to altered glucose metabolism and thereby may contribute to the induction of type 2 diabetes mellitus.
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Rakesh S
authors.initials: RS
authors.lastname: Birjmohun
authors.forename: Radjesh J
authors.initials: RJ
authors.lastname: Bisoendial
authors.forename: Sander I
authors.initials: SI
authors.lastname: van Leuven
authors.forename: Mariette
authors.initials: M
authors.lastname: Ackermans
authors.forename: Aelko
authors.initials: A
authors.lastname: Zwinderman
authors.forename: John J P
authors.initials: JJ
authors.lastname: Kastelein
authors.forename: Erik S G
authors.initials: ES
authors.lastname: Stroes
authors.forename: Hans P
authors.initials: HP
authors.lastname: Sauerwein
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002097:C-Reactive Protein / Q000008:administration & dosage* / Q000494:pharmacology; D005943:Gluconeogenesis / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D001786:Blood Glucose; D011994:Recombinant Proteins; D002097:C-Reactive Protein