CRP and IL-6 concentrations are associated with poor glycemic control despite preserved beta-cell function during the first year after diagnosis of type 1 diabetes

Diabetes Metab Res Rev. May-Jun 2004;20(3):205-10. doi: 10.1002/dmrr.427.

Abstract

Background: The role of non-specific inflammation in beta-cell loss in type 1 diabetes is unclear. In the present study, inflammatory markers were determined in patients with newly diagnosed disease and related to beta-cell function, glycemic control and autoimmunity.

Methods: Ninety-seven adult patients with type 1 diabetes mellitus (80% islet antibody positives, ab(+)) were examined at diagnosis and 3, 6, 9 and 12 months after the start of insulin treatment. Plasma C-reactive protein (CRP), interleukin-6 (IL-6), C-peptide, islet autoantibodies, insulin requirement and HbA(1c) were assessed.

Results: The concentrations of CRP were high-normal at diagnosis and did not change during the study period. A positive correlation between CRP at diagnosis and BMI was observed in ab(+) as well as in ab(-) cases. Detectable concentrations of IL-6 were found in 32% (157/485) of the samples and did not change during the study. Ab(-) patients had higher values of CRP at diagnosis and throughout the study compared to the ab(+). Among the ab(+) patients, CRP concentrations during the study were positively correlated to C-peptide at 12 months and an increase in HbA(1c) levels between 6 and 12 months. No associations between the presence or levels of islet autoantibodies and CRP were noted.

Conclusions: In type 1 diabetes, the islet destructive process and the development of beta-cell remission are not associated with changes in CRP or IL-6. Instead, elevated CRP concentrations are prevalent and seem to reflect insulin resistance, as positive associations to BMI, C-peptide and deterioration of glycemic control were observed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood
  • Blood Glucose / analysis*
  • Body Mass Index
  • C-Peptide / blood
  • C-Reactive Protein / analysis*
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin Resistance
  • Interleukin-6 / blood*
  • Inulin / therapeutic use
  • Islets of Langerhans / immunology
  • Islets of Langerhans / physiopathology*
  • Male
  • Regression Analysis

Substances

  • Autoantibodies
  • Blood Glucose
  • C-Peptide
  • Glycated Hemoglobin A
  • Interleukin-6
  • Inulin
  • C-Reactive Protein