JDC Gems

2. Is hs-CRP associated with incident diabetic nephropathy?

     Diabetes researches report that a high sensitivity C-reactive protein is associated with the prevalence of diabetic nephropathy (DN) but its association with the incidence of DN is not yet explored. On this aspect, a recent study was conducted in African Americans termed as the Jackson Heart Study.

      The study was conducted as a longitudinal analysis of data with 4,043 eligible Jackson Heart Study (JHS) participants. Incident DN was defined as urinary albumin-to-cretinine ratio (ACR) >30 mg/g or self-reported dialysis/transplantation and type 2 diabetes mellitus (DM) or HbA1c >6.5%. Kaplan-Meier curves were used to examine DN event-free survival probability by hs-CRP. With Cox proportional hazards regression estimated hazard ratios (HRs) and 95% CI for DN by hs-CRP tertiles, adjusting for demographics and clinical and laboratory data.

      During 7.8 years of median follow-up time, participants who developed DN had significantly higher baseline hs-CRP, age, fasting glucose, triglycerides, ACR, systolic blood pressure, waist circumference, and duration of DM (P < 0.05). The overall incident rate of DN was 7.9%. The mean time to incident DN was shorter for participants with hs-CRP in the high tertile ( >4.24 mg/L) than in the low tertile (<1.46 mg/L).Participants with high hs-CRP were found to had higher incidence of DN (HR 2.34, 95% CI 1.04–5.24) compared to the reference group. Inflammation, as measured by hs-CRP levels, may be associated with incident DN in AA.

      From the results of the study, it can be stated that hs-CRP is associated not only with the prevalence of DN but also with the incidence of DN.

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