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Open Access Research article

Lifestyle and clinical factors associated with elevated C-reactive protein among newly diagnosed Type 2 diabetes mellitus patients: a cross-sectional study from the nationwide DD2 cohort

Elisabeth Svensson1*, Anil Mor1, Jørgen Rungby2, Klara Berencsi1, Jens Steen Nielsen3, Jacob V Stidsen3, Søren Friborg4, Ivan Brandslund5, Jens Sandahl Christiansen6, Henning Beck-Nielsen3, Henrik Toft Sørensen1 and Reimar W Thomsen1

Author Affiliations

1 Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark

2 Department of Pharmacology, Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark

3 Diabetes Research Centre, Department of Endocrinology, Odense University Hospital, Odense, Denmark

4 Department of Endocrinology M, Odense University Hospital, Odense, Denmark

5 Department of Biochemistry, Lillebaelt Hospital Vejle, Vejle, Denmark

6 Department of Internal Medicine and Endocrinology, Institute of Clinical Medicine Aarhus University Hospital, Aarhus, Denmark

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BMC Endocrine Disorders 2014, 14:74  doi:10.1186/1472-6823-14-74

Published: 28 August 2014

Abstract

Background

We aimed to examine the prevalence of and modifiable factors associated with elevated C-reactive Protein (CRP), a marker of inflammation, in men and women with newly diagnosed Type 2 Diabetes mellitus (DM) in a population-based setting.

Methods

CRP was measured in 1,037 patients (57% male) with newly diagnosed Type 2 DM included in the prospective nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project. We assessed the prevalence of elevated CRP and calculated relative risks (RR) examining the association of CRP with lifestyle and clinical factors by Poisson regression, stratified by gender. We used linear regression to examine the association of CRP with other biomarkers.

Results

The median CRP value was 2.1 mg/L (interquartile range, 1.0 – 4.8 mg/L). In total, 405 out of the 1,037 Type 2 DM patients (40%) had elevated CRP levels (>3.0 mg/L). More women (46%) than men (34%) had elevated CRP. Among women, a lower risk of elevated CRP was observed in patients receiving statins (adjusted RR (aRR) 0.7 (95% confidence interval (CI) 0.6-0.9)), whereas a higher risk was seen in patients with central obesity (aRR 2.3 (95% CI 1.0-5.3)). For men, CRP was primarily elevated among patients with no regular physical activity (aRR 1.5 (95% CI 1.1-1.9)), previous cardiovascular disease (aRR1.5 (95% CI 1.2-1.9) and other comorbidity. For both genders, elevated CRP was 1.4-fold increased in those with weight gain >30 kg since age 20 years. Sensitivity analyses showed consistent results with the full analysis. The linear regression analysis conveyed an association between high CRP and increased fasting blood glucose.

Conclusions

Among newly diagnosed Type 2 DM patients, 40% had elevated CRP levels. Important modifiable risk factors for elevated CRP may vary by gender, and include low physical activity for men and central obesity and absence of statin use for women.

Keywords:
C-reactive protein; Lifestyle factors; Obesity; Physical activity