Abstract
BackgroundAlbuminuria is one of the first asymptomatic clinical manifestations of microvascular damage in type 2 diabetes. High-sensitivity C-reactive protein (hs-CRP), Asymmetric dimethylarginine (ADMA), and nitric oxide (NO) are important risk factors for endothelial dysfunction. The aim of this study is to evaluate hs-CRP, ADMA, and NO levels and their correlations in patients with type 2 diabetes respect to their albuminuric states. MethodsWe quantified serum hs-CRP, ADMA, and NO levels in 40 microalbuminuric (urinary albumin excretion ≤30mg/day and <300mg/day) type 2 diabetic patients and 40 age, gender, and body mass index (BMI)-matched normoalbuminuric (urinary albumin excretion <30mg/day) diabetic patients in this case-control study. ResultsThe mean value of albuminuria was 238±58mg/day in the microalbuminuric group and 12.6±4.7mg/day in the normoalbuminuric group. Creatinine was significantly higher and GFR was significantly lower in group with microalbuminuria than normoalbuminuria (p<0.05). Albuminuric diabetic patients had significantly higher hs-CRP levels as compared to normoalbuminuric group (3.9±0.8mg/dL versus 5.7±1.4mg/dL, p<0.05). However there were no significant differences in ADMA and NO between two groups but the ADMA/NO ratio was significantly higher in albuminuric group comparing with normoalbuminuric one (0.017 vs. 0.015, p value <0.05). In control group (normoalbuminuria) age, gender and BMI-adjusted ADMA indicated a significant and positive correlation with NO (r=0.430, p value=0.022) and with hs-CRP (r=0.362, p value=0.041), and also a significant and positive correlation was found between hs-CRP and NO in case group (with microalbuminuria) (r=0.370, p value=0.026). ConclusionHs-CRP was higher in microalbuminuric patients with type 2 diabetes compare to normoalbuminuric group. Also we found changing association among ADMA, NO and hs-CRP from normoalbuminuric to albuminuric state which this finding may be linked to the role of basic inflammation in confounding some interactions and creating some new ones.
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