Acute Phase Reactants in Type 2 Diabetes Mellitus and Their Correlation with the Duration of Diabetes Mellitus

Introduction: Poorly controlled blood glucose levels can lead to complications in type 2 diabetes mellitus. The risk of the complications increases with an increase in the duration of hyperglycaemia. Numerous studies have shown the association between chronic subclinical inflammation and the risk of developing type 2 diabetes. Acute phase reactants are the markers of inflammation. In our study, we assessed the correlation of the levels of the acute phase reactants with an increase in the duration of diabetes mellitus. We also studied the correlation between these acute phase reactants with the traditional risk predictors of diabetic complications. Materials and Methods: This was a case control study which included 60 uncontrolled, type 2, diabetes mellitus cases and 30 non-diabetic, apparently normal controls. The cases were classified into two groups. Group I comprised of 30 cases which had a duration of diabetes of less than 10 years and group II comprised of 30 cases which had a duration of diabetes of more than 10 years. Three acute phase reactants; C reactive protein, ceruloplasmin and total sialic acid were assessed as the markers of inflammation. Cardiovascular risk was assessed by measuring the lipid profile. 24 hour urinary albumin was measured as a marker of incipient diabetic nephropathy. Results: A significant increase was seen in all the three acute phase reactants in group I as compared to those in the controls (P<0.01). The increase in these acute phase reactants was more significant (P<0.001) in group II as compared to that in group I. There was a significant positive correlation between all the acute phase reactants, C reactive protein (r=0.9, P<0.001), ceruloplasmin (r=0.3, P<0.001) and total sialic acid (r=0.9, P<0.001) and the LDL: HDL cholesterol ratio in group II. A significant positive correlation was also seen between C reactive protein (r=0.5, P<0.001), ceruloplasmin (r=0.9, P<0.001) and total sialic acid (r=0.9, P<0.001) and the 24 hour urinary albumin in group II. Conclusion: There was a significant increase in the level of the acute phase reactants with an increase in the duration of diabetes mellitus. There was a significant correlation between inflammation and the diabetic complications.