Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 9;20(1):220.
doi: 10.1186/s12933-021-01409-0.

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

Shahnam Sharif  1 , Y Van der Graaf  2 , M J Cramer  3 , L J Kapelle  4 , G J de Borst  5 , Frank L J Visseren  1 , Jan Westerink  6 ; SMART study group
Collaborators, Affiliations

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

Shahnam Sharif et al. Cardiovasc Diabetol. .

Abstract

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-CRP, is an independent risk factor for vascular- and all-cause mortality but not for cardiovascular events in high-risk type 2 diabetes patients. Chronic low-grade inflammation may be a treatment target to lower residual cardiovascular risk in type 2 diabetes patients.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Emerging Risk Factors C. Seshasai SR, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, Whincup PH, Mukamal KJ, Gillum RF, Holme I, Njolstad I, Fletcher A, Nilsson P, Lewington S, Collins R, Gudnason V, Thompson SG, Sattar N, Selvin E, Hu FB, Danesh J. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011;364:829–841. doi: 10.1056/NEJMoa1008862. - DOI - PMC - PubMed
    1. Fox CS. Cardiovascular disease risk factors, type 2 diabetes mellitus, and the Framingham Heart Study. Trends Cardiovasc Med. 2010;20:90–95. doi: 10.1016/j.tcm.2010.08.001. - DOI - PMC - PubMed
    1. Stam-Slob MC, van der Graaf Y, de Borst GJ, Cramer MJ, Kappelle LJ, Westerink J, Visseren FL, Group SS Effect of type 2 diabetes on recurrent major cardiovascular events for patients with symptomatic vascular disease at different locations. Diabetes Care. 2015;38:1528–1535. doi: 10.2337/dc14-2900. - DOI - PubMed
    1. Engelen SE, van der Graaf Y, Stam-Slob MC, Grobbee DE, Cramer MJ, Kappelle LJ, de Borst GJ, Visseren FLJ, Westerink J, Group SS : Incidence of cardiovascular events and vascular interventions in patients with type 2 diabetes. Int J Cardiol. 2017 doi: 10.1016/j.ijcard.2017.07.081. - DOI - PubMed
    1. Tancredi M, Rosengren A, Svensson AM, Kosiborod M, Pivodic A, Gudbjornsdottir S, Wedel H, Clements M, Dahlqvist S, Lind M. Excess mortality among persons with type 2 diabetes. N Engl J Med. 2015;373:1720–1732. doi: 10.1056/NEJMoa1504347. - DOI - PubMed

MeSH terms