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

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 cardiovascu...

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Autores principales:	Shahnam Sharif, Y. Van der Graaf, M. J. Cramer, L. J. Kapelle, G. J. de Borst, Frank L. J. Visseren, Jan Westerink, the SMART study group
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/d111bce3c9f04bb99a2b41879fa13076
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spelling	oai:doaj.org-article:d111bce3c9f04bb99a2b41879fa130762021-11-14T12:15:50ZLow-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes10.1186/s12933-021-01409-01475-2840https://doaj.org/article/d111bce3c9f04bb99a2b41879fa130762021-11-01T00:00:00Zhttps://doi.org/10.1186/s12933-021-01409-0https://doaj.org/toc/1475-2840Abstract 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.Shahnam SharifY. Van der GraafM. J. CramerL. J. KapelleG. J. de BorstFrank L. J. VisserenJan Westerinkthe SMART study groupBMCarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiovascular Diabetology, Vol 20, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Shahnam Sharif Y. Van der Graaf M. J. Cramer L. J. Kapelle G. J. de Borst Frank L. J. Visseren Jan Westerink the SMART study group Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
description	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.
format	article
author	Shahnam Sharif Y. Van der Graaf M. J. Cramer L. J. Kapelle G. J. de Borst Frank L. J. Visseren Jan Westerink the SMART study group
author_facet	Shahnam Sharif Y. Van der Graaf M. J. Cramer L. J. Kapelle G. J. de Borst Frank L. J. Visseren Jan Westerink the SMART study group
author_sort	Shahnam Sharif
title	Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
title_short	Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
title_full	Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
title_fullStr	Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
title_full_unstemmed	Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
title_sort	low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d111bce3c9f04bb99a2b41879fa13076
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Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes

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