A1 Refereed original research article in a scientific journal
High-sensitivity C-reactive protein and impaired coronary vasoreactivity in young men with uncomplicated type 1 diabetes
Authors: Sundell J, Ronnemaa T, Laine H, Raitakari OT, Luotolahti M, Nuutila P, Knuuti J
Publisher: SPRINGER
Publication year: 2004
Journal: Diabetologia
Journal name in source: DIABETOLOGIA
Journal acronym: DIABETOLOGIA
Volume: 47
Issue: 11
First page : 1888
Last page: 1894
Number of pages: 7
ISSN: 0012-186X
DOI: https://doi.org/10.1007/s00125-004-1543-z
Abstract
Aims/hypothesis. Elevated high-sensitivity C-reactive protein (hsCRP) concentrations indicate increased risk of future coronary events. The association between hsCRP and coronary vasoreactivity has not yet been examined in type I diabetic subjects.Methods. We studied 18 young men who were non-smokers and who had uncomplicated type I diabetes. The diabetic subjects were divided into two groups, according to their median hsCRP concentration, as follows: (i) subjects with slightly elevated hsCRP (median 0.76 mg/l, range 0.47-4.73 mg/l, n=8); and (11) subjects with low hsCRP (median 0.32 mg/l, range 0.11-0.35 mg/l, n=10). In addition we investigated 22 non-diabetic age-matched subjects (hsCRP: median 0.42 mg/l, range 0.11-1.31 mg/l). Resting myocardial blood flow and hyperaemic adenosine-stimulated flow during euglycaemic-hyperinsulinaemic clamp were determined using positron emission tomography and oxygen-(15)-labelled water.Results. Diabetic subjects with slightly elevated hsCRP had significantly higher hsCRP concentrations than nondiabetic subjects (p=0.008). Resting myocardial blood flow was similar (NS) in diabetic subjects with slightly elevated hsCRP (0.79 +/- 0.19 ml.g(-1).min(-1)) or low hsCRP (0.81 +/- 0.15 ml.g(-1).min(-1)) and non-diabetic subjects (0.80 +/- 0.19 ml.g(-1).min(-1)). Adenosine infusion induced a significant increase in blood flow in all study subjects (p<0.001) but was blunted in diabetic subjects with slightly elevated hsCRP (3.42 +/- 0.61 ml&BULL;g(-1)&BULL;min(-1)) when compared with diabetic subjects with low hsCRP (5.08 +/- 1.65 ml&BULL;g(-1)&BULL;min(-1), p=0.02) or non-diabetic subjects (4.51 +/- 1.36 ml&BULL;g(-1)&BULL;min(-1), p=0.04). Adenosine-stimulated flow was inversely correlated with hsCRP concentrations in all diabetic subjects (r=-0.70, p=0.001).Conclusions/interpretation. In young subjects with uncomplicated type I diabetes, even slightly elevated hsCRP concentrations are associated with reduced coronary vasoreactivity.
Aims/hypothesis. Elevated high-sensitivity C-reactive protein (hsCRP) concentrations indicate increased risk of future coronary events. The association between hsCRP and coronary vasoreactivity has not yet been examined in type I diabetic subjects.Methods. We studied 18 young men who were non-smokers and who had uncomplicated type I diabetes. The diabetic subjects were divided into two groups, according to their median hsCRP concentration, as follows: (i) subjects with slightly elevated hsCRP (median 0.76 mg/l, range 0.47-4.73 mg/l, n=8); and (11) subjects with low hsCRP (median 0.32 mg/l, range 0.11-0.35 mg/l, n=10). In addition we investigated 22 non-diabetic age-matched subjects (hsCRP: median 0.42 mg/l, range 0.11-1.31 mg/l). Resting myocardial blood flow and hyperaemic adenosine-stimulated flow during euglycaemic-hyperinsulinaemic clamp were determined using positron emission tomography and oxygen-(15)-labelled water.Results. Diabetic subjects with slightly elevated hsCRP had significantly higher hsCRP concentrations than nondiabetic subjects (p=0.008). Resting myocardial blood flow was similar (NS) in diabetic subjects with slightly elevated hsCRP (0.79 +/- 0.19 ml.g(-1).min(-1)) or low hsCRP (0.81 +/- 0.15 ml.g(-1).min(-1)) and non-diabetic subjects (0.80 +/- 0.19 ml.g(-1).min(-1)). Adenosine infusion induced a significant increase in blood flow in all study subjects (p<0.001) but was blunted in diabetic subjects with slightly elevated hsCRP (3.42 +/- 0.61 ml&BULL;g(-1)&BULL;min(-1)) when compared with diabetic subjects with low hsCRP (5.08 +/- 1.65 ml&BULL;g(-1)&BULL;min(-1), p=0.02) or non-diabetic subjects (4.51 +/- 1.36 ml&BULL;g(-1)&BULL;min(-1), p=0.04). Adenosine-stimulated flow was inversely correlated with hsCRP concentrations in all diabetic subjects (r=-0.70, p=0.001).Conclusions/interpretation. In young subjects with uncomplicated type I diabetes, even slightly elevated hsCRP concentrations are associated with reduced coronary vasoreactivity.
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