Elevated level of C-reactive protein is associated with risk of prediabetes in Indians

Abstract

Background: Relationship of high sensitivity C-reactive protein (hsCRP) with prediabetes has not been explored extensively in Indians. Here we sought to investigate the association of hsCRP levels with prediabetes, as represented by Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) and the influence of risk factors like obesity, decreased HDL cholesterol, hypertension, family history of diabetes and current smoking habit on the relationship. Methods: A cross-sectional study on 1726 Indians, comprising of 1276 individuals with Normal Glucose Tolerance (NGT), 250 IFG and 200 IGT individuals. Subjects were defined according to WHO criteria based on fasting plasma and 2 h glucose levels. Results: Median levels of hsCRP were significantly higher in IFG (2.20 mg/l) and IGT (2.32 mg/l) compared to NGT (1.64 mg/l) subjects. Individuals with high risk hsCRP levels (>3 mg/l) had an Odds Ratio (OR) (95% Confidence Interval (CI)) of 2.60 (1.56–5.34) [P = 1.3 × 10⁻⁴] for IGT after adjusting the effect of age, sex, medication, Body Mass Index (BMI), Waist Circumference (WC) and risk factors like decreased high-density lipoprotein cholesterol (HDL-cholesterol), hypertension, family history of diabetes and current smoking. Significant increase in risk of IGT was found with a unit increase in natural log transformed hsCRP levels after adjustment for covariates [OR (95%CI) = 1.57 (1.27–1.94), P = 3.0 × 10⁻⁵]. When subjects were stratified on the basis of risk factors, we found stronger association of elevated hsCRP levels with risk of IFG and IGT in subjects having HDL-cholesterol ≤50 mg/dl and with hypertension. Conclusions: Our study demonstrates that elevated hsCRP levels are independently associated with risk of IFG and IGT in Indians.