title: Association between plasma high-sensitivity C-reactive protein and insulin resistance and white matter lesions in Japanese type 2 diabetic patients.
abstract: The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. High-sensitivity C-reactive protein (HSCRP), which is associated with diabetes, has been flagged as a novel predictor for cerebrovascular events. This preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with HSCRP and insulin resistance in type 2 diabetic patients not receiving insulin treatment. Based on brain magnetic resonance imaging (MRI) findings, 102 type 2 diabetic patients were divided into two groups; a WML-positive group (59+/-6 years, mean+/-SD, n=40) and a WML-negative group (58+/-6 years, n=62). The level of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin (F-IRI), homeostasis model assessment (HOMA) index, and Hemoglobin A1c (HbA1c). The body mass index was higher in the WML-positive group than in the WML-negative group (p<0.05). Plasma levels of triglycerides were higher while high-density lipoprotein cholesterol (HDL-C) was lower in the WML-positive group than in the WML-negative group (p<0.01 and p<0.005, respectively). Fasting plasma glucose (p<0.005), insulin concentrations (p<0.0001), HOMA index (p<0.0001), and HSCRP (<0.0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high HSCRP and insulin resistance (p<0.005, p<0.0005, respectively). The results of this preliminary study indicate that the presence of WML was associated with the high HSCRP and insulin resistance in these Japanese patients with type 2 diabetes mellitus; larger cohort studies are warranted to confirm these findings.
authors.affiliation: Department of Cardiology, Oita Red Cross Hospital, Japan. anan-f@med.oita-u.ac.jp
authors.forename: Futoshi
authors.initials: F
authors.lastname: Anan
authors.forename: Takayuki
authors.initials: T
authors.lastname: Masaki
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Tetsu
authors.initials: T
authors.lastname: Iwao
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shimomura
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Umeno
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Eshima
authors.forename: Tetsunori
authors.initials: T
authors.lastname: Saikawa
authors.forename: Hironobu
authors.initials: H
authors.lastname: Yoshimatsu
mesh_terms: D000368:Aged; D001794:Blood Pressure; D001921:Brain / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D020521:Stroke / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D002097:C-Reactive Protein; D003404:Creatinine