Predicting value of high-sensitive C-reactive protein on progression of common carotid artery intima- media thickness in newly diagnosed type 2 diabetes

Objective To investigate the predicting value of high-sensitive C-reactive protein (hsCRP) level on progression of intima-media thickness of common carotid artery (CCA-IMT) in patients with newly diagnosed type 2 diabetes (T2DM). Methods CCA-IMT was assessed using non-invasive high resolution B-mode ultrasonography and plasma level of hsCRP was determined with latex-enhanced immunonephelometer method in 318 patients with newly diagnosed T2DM and 112 controls. Multifactorial targeted intervention was implemented for 170 T2DM patients with a length of course equal to or less than one year and without atherosclerosis to disclose factors affecting progression of CCA-IMT. Results CCA-IMT was greater in T2DM patients with hsCRP level at the top quartile than that in those with hsCRP levels at other three quartiles (P0.05). CCA-IMT correlated linearly with plasma level of hsCRP in T2DM patients (r=0.145, P=0.008). Multivariate analysis showed that history of hypertension and alcohol comsumption, plasma levels of high-density lipoprotein-cholesterol (HDL-C) and glycosylated hemoglobin A1c (HbA1c) in patients with T2DM were all independent factors associated with their plasma level of hsCRP. Two years after intensive multifactorial intervention, plasma level of hsCRP [0.50 mg/L (0.01~6.63 mg/L)] significantly lowered in patients of T2DM, as compared to the baseline [0.60 mg/L (0.04~7.84 mg/L), P0.01], but no difference in CCA-IMT before [(0.71±0.09) mm] and after [(0.70±0.21) mm] intervention was found (P0.05). Decrement of hsCRP level in patients without progression of CCA-IMT [0.01 mg/L(-7.75~2.93 mg/L)] was significantly greater than that in those with progression [0.07 mg/L(-6.47~7.36 mg/L), P0.01]. Logistic regression analysis showed that decrement of hsCRP level was independently correlated with CCA-IMT two years after intervention. Conclusion Plasma level of hsCRP could be lowered by multifactorial intervention for patients with T2DM, which could be used to predict progression of CCA-IMT.