DOI: http://dx.doi.org/10.18203/2349-2902.isj20175400

Correlation of CRP level with glycemic control in diabetic foot patients and its sequelae

Anand A., Maragathamani .

Abstract


Background:Diabetes mellitus is a major public health problem globally and in Indian population and diabetic foot is reported as the most common cause of non-traumatic amputation of the lower limbs in India. There is renewed interest in various inflammatory markers and their association with various chronic complications of diabetes mellitus. There is a scarcity of data on the subject in Indian population.

Methods: The current study was a cross sectional study of 100 patients admitted to a Diabetic foot in Department of General Surgery, Stanley medical college and Hospital between January 2012-November 2012. The CRP level and fasting and plasma glucose levels were considered as the relevant variables for statistical analysis.

Results:A total of 100 patients were included in the final analysis. The proportion of subjects with Wagners, grade 1, grade 2, 3, 4 and 5 ulcers were 48%, 27%, 16%, 3% and 6% respectively. Among the study population, 73% of patients had CRP value greater than 40 and 27% patients had CRP value less than 40. The proportion of subjects with Higher CRP level (>40) showed increasing trend with increasing level of fasting blood sugar and post prandial blood sugar in the study population. The proportion of people who underwent amputation was 27.5% in people with CRP value >40 and it was only 6.85% of people with CRP value <40, the association between CRP values and amputation was statistically significant. (P value 0.046).

Conclusions:The study has established a strong positive association between poor blood sugar control and elevated CRP levels in the study population. The study has also documented a positive association between higher CRP levels and amputation.


Keywords


Amputation, C-Reactive protein, Diabetic foot, Diabetes mellitus

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References


Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. New England J Med. 2005;352(16):1685-95.

Atherosclerosis RR. An inflammatory disease. New Engl J Med. 1999;340:115-26.

Pai JK, Pischon T, Ma J, Manson JE, Hankinson SE, Joshipura K, et al. Inflammatory markers and the risk of coronary heart disease in men and women. New England J Med. 2004;351(25):2599-610.

Ridker PM WP, Grundy SM. Should C-reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk?. Circulation. 2004;109:2818-25.

Schulze MB, Rimm EB, Li T, Rifai N, Stampfer MJ, Hu FB. C-reactive protein and incident cardiovascular events among men with diabetes. Diabetes Care. 2004;27(4):889-94.

Jialal I DS, Venugopal SK. C-reactive protein: risk marker or mediator in atherothrombosis?. Hypertension. 2004;44(1):6-11.

Venugopal SK DS, Jialal I. C-reactive protein decreases prostacyclin release from human aortic endothelial cells. Circulation. 2003;108:1676-8.

Pasceri V WJ, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation. 2000;102:2165-8.

Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV, et al. A self-fulfilling prophecy. Circulation. 2002;106(8):913-9.

Aronson D, Bartha P, Zinder O, Kerner A, Shitman E, Markiewicz W, et al. Association between fasting glucose and C‐reactive protein in middle‐aged subjects. Diabetic Medicine. 2004;21(1):39-44.

De Rekeneire N, Peila R, Ding J, Colbert LH, Visser M, Shorr RI, et al. Diabetes, hyperglycemia, and inflammation in older individuals. Diabetes Care. 2006;29(8):1902-8.

King DE MAr, Buchanan TA, Pearson WS. C-reactive protein and glycemic control in adults with diabetes. Diabetes Care. 2003;26:1535-9.

Bruno G, Fornengo P, Novelli G, Panero F, Perotto M, Segre O, et al. C-reactive protein and 5-year survival in type 2 diabetes: the Casale Monferrato Study. Diabetes. 2009;58(4):926-33.

Ford ES. Body mass index, diabetes, and C-reactive protein among US adults. Diabetes care. 1999;22(12):1971-7.

Haffner S LS, Ro ̈nnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339:229-34.

Mendes JJ, Marques-Costa A, Vilela C, Neves J, Candeias N, Cavaco-Silva P, et al. Clinical and bacteriological survey of diabetic foot infections in Lisbon. Diabetes Research Clinical Practice. 2012;95(1):153-61.

Bengalorkar GM NK. Diabetic foot infections-A review. Int J Biol Med Res. 2011;2(1):453- 60.

Singh N AD, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217-28.

Driver VR, Madsen J, Goodman RA. Reducing amputation rates in patients with diabetes at a military medical center. Diabetes Care. 2005;28(2):248-53.

Standage SW WH. Biomarkers for pediatric sepsis and septic shock. Expert Rev Anti Infect. 2011;9(1):71-9.

Cavanagh PR LB, Bradbury AW, Botek G. Treatment for diabetic foot ulcers. Lancet. 2005;366:1725-35.