Raised C-reactive protein levels in patients with recent onset type 1 diabetes

Background To investigate serum concentrations of high-sensitive Creactiveprotein (CRP) and alpha(1)-acid glycoprotein (AGP) in patientswith T1DM, at diagnosis and after 12 months of intensive insulin therapy(T12).Methods CRP and AGP were measured in 44 recent onset T1DM patients(26M/18F, mean age 14.9 ± 9.1 years), and 44 age- and sex-matchedcontrols, using a highly sensitive immunonephelometric assay.Results There were no significant differences in the concentrations of highsensitiveC-reactive protein (hs-CRP) and AGP between patients and controls.hs-CRP levels significantly increased in patients at T12 compared to the levelsat diagnosis [0.69 (0.14–15.5) versus 0.43 (0.14–7.47) mg/L, p < 0.05;for males: 0.77 (0.14–15.5) versus 0.35 (0.14–7.47) mg/L, p < 0.05; forfemales the increase was not significant]. AGP levels were not different atT12 compared to diagnosis. No significant correlations were found betweenhs-CRP and body mass index (BMI), C-peptide, glycosylated haemoglobin,or insulin dose. A strong correlation was found between hs-CRP values atdiagnosis and those at T12 (ρ = 0.73, p < 0.001); indeed, patients withhs-CRP levels above the 50th percentile at diagnosis showed significantlyincreased hs-CRP values at T12 compared to patients with baseline hs-CRPlevels under the 50th percentile [1.61 (0.18–15.5) versus 0.16 (0.14–1.92)mg/L, p < 0.0001)], and to controls [0.55 (0.14–6.50), p = 0.001].Conclusions This is the first report showing that, despite good metaboliccontrol, 1 year of overt T1DM is sufficient to increase hs-CRP levels, especiallyin males. hs-CRP levels at diagnosis is a predictor for the values observedat 12 months, suggesting the possibility to select a subgroup of patientsrequiring strict follow-up for cardiovascular complications.