Plasma concentration of C-reactive protein is increased in type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: evidence for chronic inflammation

Diabetologia. 1999 Mar;42(3):351-7. doi: 10.1007/s001250051162.


Moderately increased plasma concentrations of C-reactive protein are associated with an increased risk of cardiovascular disease. C-reactive protein, its relation to a low degree of inflammatory activation and its association with activation of the endothelium have not been systematically investigated in Type I (insulin-dependent) diabetes mellitus. C-reactive protein concentrations were measured in 40 non-smoking patients with Type I diabetes without symptoms of macrovascular disease and in healthy control subjects, and in a second group of Type I diabetic patients (n = 60) with normo- (n = 20), micro- (n = 20) or macroalbuminuria (n = 20). Differences in glycosylation of alpha1-acid glycoprotein were assayed by crossed affinity immunoelectrophoresis. Activation of the endothelium was measured with plasma concentrations of endothelial cell markers. The median plasma concentration of C-reactive protein was higher in Type I diabetic patients compared with healthy control subjects [1.20 (0.06-21.64) vs. 0.51 (0.04-9.44) mg/l; p<0.02]. The Type I diabetic subjects had a significantly increased relative amount of fucosylated alpha1-acid glycoprotein (79+/-12% vs. 69+/-14% in the healthy control subjects; p<0.005), indicating a chronic hepatic inflammatory response. In the Type I diabetic group, log(C-reactive protein) correlated significantly with von Willebrand factor (r = 0.439, p<0.005) and vascular cell adhesion molecule-1 (r = 0.384, p<0.02), but not with sE-selectin (r = 0.008, p = 0.96). In the second group of Type I diabetic patients, increased urinary albumin excretion was associated with a significant increase of von Willebrand factor (p<0.0005) and C-reactive protein (p = 0.003), which were strongly correlated (r = 0.53, p<0.0005). Plasma concentrations of C-reactive protein were higher in Type I diabetic patients without (clinical) macroangiopathy than in control subjects, probably due to a chronic hepatic inflammatory response. The correlation of C-reactive protein with markers of endothelial dysfunction suggests a relation between activation of the endothelium and chronic inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria
  • Biomarkers / blood
  • Body Mass Index
  • C-Reactive Protein / analysis
  • C-Reactive Protein / metabolism*
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / urine
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / physiopathology
  • E-Selectin / blood
  • Endothelium, Vascular / physiology
  • Endothelium, Vascular / physiopathology*
  • Female
  • Fibrinogen / analysis
  • Glycated Hemoglobin A / analysis
  • Humans
  • Inflammation
  • Male
  • Orosomucoid / analysis
  • Phospholipases A / blood
  • Reference Values
  • Regression Analysis
  • Vascular Cell Adhesion Molecule-1 / blood
  • von Willebrand Factor / analysis


  • Biomarkers
  • E-Selectin
  • Glycated Hemoglobin A
  • Orosomucoid
  • Vascular Cell Adhesion Molecule-1
  • von Willebrand Factor
  • Fibrinogen
  • C-Reactive Protein
  • Phospholipases A