Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

作者：Shahnam Sharif, Yolanda van der Graaf, Maarten J. Cramer, L.J. Kapelle, Gert J. de Borst, Frank L.J. Visseren, Jan Westerink, the SMART study group, Rutger van Petersen, B. G. F. Dinther, Ale Algra, Yolanda van der Graaf, Diederick E. Grobbee, Guy E.H.M. Rutten, Frank L.J. Visseren, Gert J. de Borst, L. Jaap Kappelle, Tim Leiner, Hendrik M. Nathoe · 发表于：Cardiovascular Diabetology · 年份：2021 · DOI：10.1186/s12933-021-01409-0 · 被引用次数：209 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Inflammatory Biomarkers in Disease Prognosis、Cardiovascular Disease and Adiposity

BACKGROUND: Type 2 diabetes is a condition associated with a state of low-grade inflammation caused by adipose tissue dysfunction and insulin resistance. High sensitive-CRP (hs-CRP) is a marker for systemic low-grade inflammation and higher plasma levels have been associated with cardiovascular events in various populations. The aim of the current study is to evaluate the relation between hs-CRP and incident cardiovascular events and all-cause mortality in high-risk type 2 diabetes patients. METHODS: Prospective cohort study of 1679 type 2 diabetes patients included in the Second Manifestations of ARTerial disease (SMART). Cox proportional hazard models were used to evaluate the risk of hs-CRP on cardiovascular events (composite of myocardial infarction, stroke and vascular mortality) and all-cause mortality. Hs-CRP was log-transformed for continuous analyses. Findings were adjusted for age, sex, BMI, current smoking and alcohol use, non-HDL-cholesterol and micro-albuminuria. RESULTS: 307 new cardiovascular events and 343 deaths occurred during a median follow-up of 7.8 years (IQR 4.2-11.1). A one unit increase in log(hs-CRP) was related to an increased vascular- and all-cause mortality risk (HR 1.21, 95% CI 1.01-1.46 and HR 1.26, 95% CI 1.10-1.45 respectively). No relation was found between log(hs-CRP) and myocardial infarction or stroke. The relations were similar in patients with and without previous vascular disease. CONCLUSION: Low grade inflammation, as measured by hs-C...