title: Change in hemoglobin A(1c) and C-reactive protein levels in patients with diabetes mellitus.
abstract: The authors studied the effects on C-reactive protein (CRP) levels of an intensive intervention to reduce hemoglobin A(1c) (HbA(1c)) among 58 veterans with type 2 diabetes. Weekly group sessions of behavioral and pharmacologic intervention were conducted for 4 weeks at Providence Veterans Affairs Medical Center. Change in cardiovascular risk factors and CRP levels were compared at baseline and 3 months postintervention. There was a significant decrease in HbA(1c) (-0.7%+/-1.9%, P<.01), total cholesterol (-20.3+/-41.1 mg/dL, P=.01), low-density lipoprotein cholesterol (-11.7+/-31.4 mg/dL, P=.05), systolic blood pressure (-6.9+/-21.2 mm Hg, P=.03), and diastolic blood pressure (-6.0+/-10.6 mm Hg, P<.01) over 4 months. There was no significant change in CRP levels (1.1+/-6.6 mg/L, P=.2). These results suggest that CRP effects may not be adequate to predict changes in cardiovascular risk among diabetic patients and should not be a surrogate for achieving evidence-based goals in traditional cardiovascular risk factors.
authors.affiliation: Target Research Enhancement Program at the Providence Veterans Affairs Medical Center, Providence, RI 02908, USA.
authors.forename: Sameed Ahmed M
authors.initials: SA
authors.lastname: Khatana
authors.forename: Tracey H
authors.initials: TH
authors.lastname: Taveira
authors.forename: Gaurav
authors.initials: G
authors.lastname: Choudhary
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Wu
mesh_terms: D000368:Aged; D001521:Behavior Therapy; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D004032:Diet; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D014728:Veterans
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human