C-Reactive Protein Predicts the Deterioration of Glycemia in Chinese Subjects With Impaired Glucose Tolerance

• Published in: Diabetes care Vol. 26; no. 8; pp. 2323 - 2328
• Main Authors: TAN, Kathryn C. B, WAT, Nelson M. S, TAM, Sidney C. F, JANUS, Edward D, LAM, T. H, LAM, Karen S. L
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-08-2003
• Subjects: Adult; Aged; Asian Continental Ancestry Group; Biological and medical sciences; C-reactive protein; C-Reactive Protein - metabolism; Chinese; Development and progression; Dextrose; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glucose; Glucose Intolerance - blood; Glucose Intolerance - diagnosis; Glucose Intolerance - epidemiology; Health aspects; Hong Kong - epidemiology; Humans; Hyperglycemia - blood; Hyperglycemia - diagnosis; Hyperglycemia - epidemiology; Hypoglycemia; Male; Management. Various non-drug treatments. Langerhans islet grafts; Measurement; Medical sciences; Middle Aged; Physiological aspects; Plasma; Predictive Value of Tests; Prevalence; Proteins; Risk Factors; Sensitivity and Specificity; Tropical medicine; Hong Kong; Asia; China; Endocrinopathy; Type 2 diabetes; Human; Follow up study; Chinese; Complication; Predictive factor; C reactive protein; Impaired glucose tolerance; Blood plasma
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.26.8.2323

C-Reactive Protein Predicts the Deterioration of Glycemia in Chinese Subjects With Impaired Glucose Tolerance
Kathryn C.B. Tan , MD 1 ,
Nelson M.S. Wat , MBBS 1 ,
Sidney C.F. Tam , MD 2 ,
Edward D. Janus , PHD 2 ,
T.H. Lam , MD 3 and
Karen S.L. Lam , MD 1
1 Department of Medicine, Queen Mary Hospital, Hong Kong, China
2 Clinical Biochemistry Unit, Queen Mary Hospital, Hong Kong, China
3 Department of Community Medicine, University of Hong Kong, Hong Kong, China
Address correspondence and reprint requests to Professor Karen Lam, Department of Medicine, Queen Mary Hospital, Pokfulam
Road, Hong Kong, China. E-mail: ksllam{at}hkucc.hku.hk
Abstract
OBJECTIVE —Recent studies have shown that C-reactive protein (CRP) predicts future risk of diabetes in healthy Caucasians. We determined
whether plasma CRP level was elevated in Chinese subjects with impaired glucose tolerance (IGT) and whether CRP level could
be used to predict progression to type 2 diabetes or reversion to normal glucose tolerance (NGT) in these high-risk individuals.
RESEARCH DESIGN AND METHODS —A total of 228 subjects with IGT at baseline from the Hong Kong Cardiovascular Risk Factors Prevalence Study underwent repeat
oral glucose tolerance testing after 2 years. Plasma high-sensitivity CRP was measured from their stored baseline samples
and from 228 subjects with NGT matched for age and BMI by an immunoturbidimetric assay.
RESULTS —Subjects with IGT at baseline had higher plasma CRP levels than subjects with NGT: 1.18 mg/l (0.52–2.52) vs. 0.87 mg/l (0.37–1.84),
median (interquartile range), P = 0.01. At 2 years, 117 subjects with IGT reverted to NGT, 84 remained in IGT, and 21 progressed to diabetes. Individuals
who progressed to diabetes had the highest plasma CRP levels at baseline ( P < 0.0001). Those with baseline CRP levels in the third and top quartile had a relative risk of remaining in IGT or progressing
to diabetes of 2.87 (95% CI 1.06–7.82) and 2.76 (1.06–7.31), respectively, after adjusting for anthropometric measure and
lifestyle factors.
CONCLUSIONS —CRP independently predicts the risk of remaining in IGT or progressing to diabetes in Chinese subjects with IGT. CRP might
provide an adjunctive measure for identifying subjects with the highest risk of progression to diabetes who would derive the
greatest benefits from preventive interventions.
apoB, apolipoprotein B
CRP, C-reactive protein
HOMA-IR, homeostasis model assessment index of insulin resistance
IGT, impaired glucose tolerance
NGT, normal glucose tolerance
OGTT, oral glucose tolerance test
WHO, World Health Organization
Footnotes
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted April 17, 2003.
Received February 15, 2003.
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