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Clinical and metabolic factors associated with chronic low-grade inflammation in type 2 diabetic patients

Abstract

Aim. To identify the clinical and metabolic factors associated with serum concentration of high sensitivity C-reactive protein (hsCRP) and α1-acid glycoprotein (α1-AGP) in patients with type 2 diabetes.

Material and methods. The study involved 210 patients with type 2 diabetes. Levels of hsCRP and α1-AGP were measured using ELISA and compared with those of the control (30 healthy normal individuals). Levels of acute-phase proteins, fat mass and glucose variability (GV) were compared among demographic, anthropometric, biochemical and haematological parameters. The fat mass was determined with Dual-energy X-ray absorptiometry (DEXA). GV parameters including mean amplitude of glycaemic excursions, continuous overlapping net glycaemic action (CONGA), J-index, M-value and mean absolute glucose change (MAG) were derived from continuous glucose monitoring.

Results. Levels of hsCRP and α1-AGP significantly increased (p < 0.0001) in patients with diabetes compared with controls. hsCRP level positively correlated with total, truncal and android fat (r = 0.34, r = 0.28 and r = 0.31; respectively, p < 0.00004). α1-AGP level showed no relationship with fat mass but positively correlated with mean glucose, CONGA, M-value and MAG (r = 0.38, r = 0.36, r = 0.43 and r = 0.4; respectively, p < 0.0001). Patients with the highest hsCRP levels (>75 percentile) had a greater body mass index (p = 0.00009) as well as truncal and android fat mass (p = 0.04 and p = 0.03, respectively) than those with the lowest levels (<25 percentile). High level of α1-AGP (>75 percentile) was associated with urinary albumin/creatinine ratio (p = 0.01) and GV indices (M-value: p = 0.02, MAG: p = 0.04).

Conclusions. Levels of acute-phase proteins (hsCRP and α1-AGP) increased in patients with type 2 diabetes. Levels of hsCRP were associated with fat mass; meanwhile, α1-AGP levels were associated with short-time GV in these patients. The results lend support to the notion that both obesity and enhanced GV are involved in the development of chronic low-grade inflammation associated with type 2 diabetes.

About the Authors

Vadim V. Klimontov
Scientific Institute of Clinical and Experimental Lymphology
Russian Federation
MD, PhD, Professor
Competing Interests: No conflict of interest


Nadezda V. Tyan
Scientific Institute of Clinical and Experimental Lymphology
Russian Federation
MD, junior research associate
Competing Interests: No conflict of interest


Olga N. Fazullina
Scientific Institute of Clinical and Experimental Lymphology
Russian Federation
MD, junior research associate
Competing Interests: No conflict of interest


Natalia E. Myakina
Scientific Institute of Clinical and Experimental Lymphology
Russian Federation
MD, junior research associate
Competing Interests: No conflict of interest


Alexander P. Lykov
Scientific Institute of Clinical and Experimental Lymphology
Russian Federation
MD, PhD, leading research associate
Competing Interests:

No conflict of interest



Vladimir I. Konenkov
Scientific Institute of Clinical and Experimental Lymphology
Russian Federation
PhD, Professor, academician of the Russian Academy of Sciences
Competing Interests: No conflict of interest


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Klimontov V.V., Tyan N.V., Fazullina O.N., Myakina N.E., Lykov A.P., Konenkov V.I. Clinical and metabolic factors associated with chronic low-grade inflammation in type 2 diabetic patients. Diabetes mellitus. 2016;19(4):295-302. (In Russ.)

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