BACKGROUND: High-sensitivity C-reactive protein is an important biomarker of systemic inflammation. We studied the contribution to cardiovascular risk of increased high-sensitivity C-reactive protein in patients with type 2 diabetes with or without concomitant metabolic syndrome. MATERIAL/METHODS: The series included 381 patients (199 men, 182 women; median age, 66 years; age range, 50-80 years) with a mean duration of type 2 diabetes of 9+/-8 years. Standard physical examinations and laboratory investigations were administered to all patients. Modified National Cholesterol Education Program III criteria for defining the metabolic syndrome were used. High-sensitivity C-reactive protein was estimated by immunoturbidimetry and other laboratory tests using standard methods. RESULTS: High-sensitivity C-reactive protein correlated (Spearman's correlation) significantly positively with body mass index and waist size, fasting plasma triglyceride levels, apolipoprotein-B, gamma glutamyl transferase, homeostasis model assessment of insulin resistance, and fibrinogen, and negatively with high-density lipoprotein cholesterol. However, only waist, fibrinogen, apolipoprotein-B, plasma glucose, and gamma glutamyl transferase levels appeared to be associated with high-sensitivity C-reactive protein on multiple logistic regression model analyses. In those diabetic patients with concomitant metabolic syndrome, the hypertriglyceridemic waist appeared to be a major factor for an increased high-sensitivity C-reactive protein concentration. CONCLUSIONS: The hypertriglyceridemic waist contributes to the metabolic syndrome and most likely is an important factor increasing high-sensitivity C-reactive protein levels and consequently, relative coronary risk in patients with type 2 diabetes of any sex and age.

Center of Preventive Cardiology 2nd Medical Department Charles University Prague Medical Faculty in Pilsen Pilsen Czech Republic

Cardio-metabolic risk prediction should be superior to cardiovascular risk assessment in primary prevention of cardiovascular diseases