High-sensitivity C-reactive protein levels and type 2 diabetes in urban North Indians

Context: Elevated high-sensitivity C-reactive protein (hsCRP) levels have frequently been shown to be associated with type 2 diabetes (T2D); however, very little is known about this in Asian Indians, a high-risk group. Objective: The aim of the study was to assess the association of hsCRP with T2D and to determine its correlates in North Indians of Indo-European origin. Design and Patients: A cross-sectional population-based study of 2520 urban subjects, comprising 1410 T2D patients and 1110 nondiabetic subjects, was carried out and 18 metabolic traits were assessed. Results: Median hsCRP levels were significantly higher in both diabetic men and women as compared to their nondiabetic counterparts (P < 0.0001). Elevated hsCRP was positively associated with T2D (odds ratio, 1.66; 95% confidence interval, 1.21–2.28; P = 0.002) even after adjusting for markers of obesity. After adjustments for age, sex, and BMI, HbA1c was the major correlate of hsCRP in nondiabetic subjects (β = 0.28; P = 0.03). We observed that T2D patients were at higher risk for cardiovascular disease compared to nondiabetic subjects when classified into low-, intermediate-, and high-risk groups based on hsCRP levels (ptrend = 3.8 ×10−15). Conclusions: We demonstrate the association of low-grade systemic inflammation, as indicated by elevated hsCRP levels, with T2D in North Indian population. This association was independent of obesity. Obesity and glycemic control were the major correlates of hsCRP levels. Future studies are required to evaluate the influence of modulators including genetic variations on the elevation of hsCRP levels in this population.