The Association Between High Sensitive C-reactive Protein And Islet β-Cell Function, Insulin Resistance In Latent Autoimmune Diabetes In Adult

Objective:The study aimed to investigate the level of high sensitive C-Reactive Protein(hs-CRP),a chronic inflammatory marker in latent autoimmune diabetes in adult(LADA) and the association between hs-CRP and isletβcell function,insulin resistance(IR).Objects and Methods:Two hundred and ninety LADA patients,350 type 2 diabetic(T2DM) patients who were matched with LADA in sex and age,100 classical type 1 diabetic(T1DM) patients and 230 non-diabetic controls(NC) were included in this study.Hs-CRP was measured by immunoturbidimetric assay.Based on AHA/CDC recommendations on CRP testing,hs-CRP concentrations were divided into 3 groups.In this study,we'll focus on the non-acute inflammatory condition(hs-CRP＜10mg/L) in the above subjects.Results:1) The concentrations of hs-CRP increased significantly from classical T1DM,NC,LADA to T2DM[0.54(0.11-9.25) vs 0.93 (0.10-9.99) vs 1.59(0.14-9.88) vs 1.74(0.16-9.94),P＜0.001].The difference was still significant after adjusting the effect of age and Body Mass Index(BMI)(P=0.005).HOMA-IR index in LADA patients were comparable to that of T2DM,and which were both significantly higher than that of NC.2) Hs-CRP concentrations were much higher but GADA index were much lower in overweight and obese LADA patients as compared with the leaner ones(P=0.002 and P=0.003).Hs-CRP concentrations were significantly higher in LADA2 than in LADA1 patients[1.81(0.15-9.88) vs 0.95(0.19-8.12),P=0.001],however the difference was not significant anymore after adjusting the affect of BMI. Both HOMA-IR and HOMA-βindex were comparable in the two subgroups.3) There was always negative correlation between lghs-CRP and lgHOMA-βin LADA group(r=-0.174,P=0.024) no matter the effect of age,BMI,blood pressure,TG,and GADA titer were excluded or not. However,lghs-CRP was found to be an independent risk factor for logHOMA-IR in T2DM(R~2=0.145,Beta=0.200,P=0.005).Conclusion:1) Hs-CRP concentration is significantly higher in LADA as contrast to the controls implying that there may be chronic inflammation in LADA.2) The obese individuals were more prone to complicated with chronic inflammation.3) Hs-CRP may be a marker of cell impairment in LADA patients.