Sensitivity and specificity of CRP as a parameter of atherosclerosis in patients with type II diabetes mellitus

  • Authors

    • Doaa Mizar Fayoum University, Egypt
    • Hoda Hussein Najran University, KSA Fayoum University, Egypt
    • Mohammad Mashaheet Fayoum University
    • Maher Elamir Fayoum University
  • Background: Type 2 diabetes mellitus (T2DM) is an inflammatory atherosclerotic condition with high prevalence of cardiovascular disease. Elevated C-reactive protein (CRP) predicts cardiovascular events in T2DM patients.

    Objectives: Our work aimed to assess sensitivity and specificity of CRP in diagnosis and follow up of carotid atherosclerosis in T2DM patients (detected by measuring carotid intima-media thickness CIMT).

    Design and setting: It is observational cross sectional study on T2DM patients from outpatient clinic of fayoum university hospital.

    Subjects and methods: Hundred patients with T2DM were included; Group I: statin un-treated, Group II: statin treated, and fifty healthy control persons. Laboratory measurement of total cholesterol, LDL, HDL, and serum CRP levels and carotid duplex scanning were done.

    Results: The patients had higher levels of CRP and CIMT than control. There was strong correlation between CIMT and CRP level among group I and II. LDL in diagnosis of atherosclerosis disease illustrated sensitivity (80%) and specificity (4%), while HDL sensitivity (96%) and specificity (36%). CRP showed higher sensitivity (98%) and higher specificity (72%).

    Conclusion: CRP level was an important parameter of atherosclerosis with good sensitivity and specificity regardless the level of LDL and HDL.


    Keywords: Carotid Intima Media Thickness, C Reactive Protein, Type 2 Diabetes Mellitus.

  • References

    1. L Lundby-Christensen, P Almdal, B Carstensen,et al. Carotid intima-media thickness in individuals with and without type 2 diabetes: a reproducibility study. Cardiovascular Diabetology 2010, 9:40
    2. ML Bots, MK Palmer, S Dogan, et al: Intensive lipid lowering may reduce progression of carotid atherosclerosis within 12 months of treatment: the METEOR study. J Intern Med 2009, 265(6):698-707.
    3. JR Crouse, JS Raichlen, WA Riley, et al. for the METEOR Study Group: Effect of Rosuvastatin on Progression of Carotid Intima-Media Thickness in Low-Risk Individuals with Subclinical Atherosclerosis: The METEOR Trial. JAMA: The Journal of the American Medical Association 2007, 297:1344-1353.
    4. A Kablak-Ziembicka, T Przewlocki, A Sokołowski,et al. Carotid intima-media thickness, hs-CRP and TNF-_ are independently associated with cardiovascular event risk in patients with atherosclerotic occlusive disease. Atherosclerosis 2011; 214: 185–190
    5. L Biasucci, G Biasillo and a Stefanelli. Inflammatory markers, cholesterol and statins: pathophysiological role and clinical importance. Clin Chem Lab Med 2010; 48 (12):1685–1691
    6. MG Veller, C Fisher, AN Nicolaides, et al. Measurement for the ultrasonic intima-media complex thickness in normal subjects. J Vasc Surg 1993; 17:719–25 (93)90116-4.
    7. A Pfützner, E Standl, HJ Strotmann, et al. Association of high-sensitive C-reactive protein with advanced stage beta-cell dysfunction and insulin resistance in patients with type 2 diabetes mellitus. Clin Chem Lab Med. 2006; 44 (5):556-60.
    8. M Soinio, J Marniemi, M Laakso, et al. High sensitivity C-reactive protein and coronary disease mortality in patients with type 2 diabetes. Diabetes Care 2006; 29: 329-33
    9. PM Ridker, JE Buring, NR Cook, and N Rifai. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14,719 initially healthy American women. Circulation. 2003; 107 (3):391-7.
    10. S Devaraj, U Singh, I Jialal. Human C-reactive protein and the metabolic syndrome. Curr Opin Lipidol. 2009; 20(3):182-9.
    11. N Kotb, R Gaber, M Salama, et al. Clinical and biochemical predictors of increased carotid intima-media thickness in overweight and obese adolescents with type 2 diabetes, Diabetes & Vascular Disease Research 2011.
    12. M Naghavi, E falk, HS Hecht, ET al.SHAPE Task Force. From vulnerable Plaque to vulnerable patient –part III: Executive summary of the screening for heart Attack prevention and Education (SHAPE) task force report. Am J cardiol 2006; 98(2A) 2H-15H
    13. M Xu, Y Bi, Y Chen, et al. Increased C- reactive protein Associates with elevated carotid intima -media thickness in chinese adult with normal Low Density lipoprotein cholesterol. Journal of atherosclerosis and thrombosis 2013; 20.
    14. S Tsimikas, J Willerson and P Ridker. C - reactive protein and Other Emerging Blood Biomarkers to Optimize Risk Stratification of Vulnerable Patients. Journal of the American College of Cardiology 2006 Vol. 47, No. 8 Suppl C 19- 31
    15. J Cao, C Thach, T Manolio, et al. C - reactive protein, Carotid Intima-Media Thickness, and Incidence of Ischemic Stroke in the Elderly The Cardiovascular Health Study. Circulation 2003. 108:166-170.)
    16. S Kaul, RP Morrissey and GA Diamond. Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease – a perspective. Arch Intern Med 2010; 170:1073–77
    17. VM Patil, S Chaitanyakumar and V Patil. Diabetic nephropathy and its relation to inflammation. International Journal of Pharmacy and Biological Sciences 2013; 3, 117-127.
    18. C Stehouwer, M Gall, J Twisk, et al. Increased urinary albumin excretion, endothelial dysfunction and chronic low grade inflammation in type 2 diabetes: progressive, interrelated and independently associated with risk of death. Diabetes 2002; 51: 1157-1165
  • Downloads

    Additional Files

  • How to Cite

    Mizar, D., Hussein, H., Mashaheet, M., & Elamir, M. (2014). Sensitivity and specificity of CRP as a parameter of atherosclerosis in patients with type II diabetes mellitus. International Journal of Basic and Applied Sciences, 3(3), 317-321.