Elevated serum C-reactive protein level and microalbuminuria in patients with type 2 diabetes mellitus.

INTRODUCTION: Microalbuminuria is a marker of vascular endothelial damage. In addition, it is reported that high serum levels of C-reactive protein (CRP) is a novel cardiovascular risk factor that impairs endothelial function. The aim of this study was to evaluate the relationship between microalbuminuria and elevated serum level of high-sensitivity CRP (HS-CRP) in type 2 diabetic patients. MATERIALS AND METHODS: We measured serum levels of HS-CRP in 87 patients with type 2 diabetes mellitus. They were divided into a microalbuminuric group (n = 45) and those with a 24-hour urine albumin less than 30 mg/d (n = 42). The relationship of serum HS-CRP level with albuminuria and other characteristics of the patients was assessed. RESULTS: Patients with microalbuminuria were significantly older and affected by diabetes mellitus longer than those without microalbuminuria. Also, their mean HS-CRP was significantly higher (4.98 +/- 1.45 mg/L versus 2.82 +/- 2.10 mg/L; P < .001). The Pearson correlation test showed a significant correlation between HS-CRP level and urine albumin level (r = 0.43; P < .001). The specificity and sensitivity of HS-CRP for detection of microalbuminuria in were 78.5% and 68.8%, respectively, and the positive and negative predictive values were 77.5% and 70.2%, respectively. CONCLUSIONS: In type 2 diabetic patients, microalbuminuria is accompanied by elevated HS-CRP, suggesting activation of inflammatory pathways in progression of renal and cardiovascular atherosclerotic disease. As an easier and cheaper test for assessment of diabetic nephropathy, we recommend further studies on HS-CRP in diabetic patients.