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Diabetes Care 26:2323-2328, 2003
© 2003 by the American Diabetes Association, Inc.

Epidemiology/Health Services/Psychosocial Research
Original Article

C-Reactive Protein Predicts the Deterioration of Glycemia in Chinese Subjects With Impaired Glucose Tolerance

Kathryn C.B. Tan, MD1, Nelson M.S. Wat, MBBS1, Sidney C.F. Tam, MD2, Edward D. Janus, PHD2, T.H. Lam, MD3 and Karen S.L. Lam, MD1

1 Department of Medicine, Queen Mary Hospital, Hong Kong, China
2 Clinical Biochemistry Unit, Queen Mary Hospital, Hong Kong, China
3 Department of Community Medicine, University of Hong Kong, Hong Kong, China

Address correspondence and reprint requests to Professor Karen Lam, Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong, China. E-mail: ksllam{at}hkucc.hku.hk

OBJECTIVE—Recent studies have shown that C-reactive protein (CRP) predicts future risk of diabetes in healthy Caucasians. We determined whether plasma CRP level was elevated in Chinese subjects with impaired glucose tolerance (IGT) and whether CRP level could be used to predict progression to type 2 diabetes or reversion to normal glucose tolerance (NGT) in these high-risk individuals.

RESEARCH DESIGN AND METHODS—A total of 228 subjects with IGT at baseline from the Hong Kong Cardiovascular Risk Factors Prevalence Study underwent repeat oral glucose tolerance testing after 2 years. Plasma high-sensitivity CRP was measured from their stored baseline samples and from 228 subjects with NGT matched for age and BMI by an immunoturbidimetric assay.

RESULTS—Subjects with IGT at baseline had higher plasma CRP levels than subjects with NGT: 1.18 mg/l (0.52–2.52) vs. 0.87 mg/l (0.37–1.84), median (interquartile range), P = 0.01. At 2 years, 117 subjects with IGT reverted to NGT, 84 remained in IGT, and 21 progressed to diabetes. Individuals who progressed to diabetes had the highest plasma CRP levels at baseline (P < 0.0001). Those with baseline CRP levels in the third and top quartile had a relative risk of remaining in IGT or progressing to diabetes of 2.87 (95% CI 1.06–7.82) and 2.76 (1.06–7.31), respectively, after adjusting for anthropometric measure and lifestyle factors.

CONCLUSIONS—CRP independently predicts the risk of remaining in IGT or progressing to diabetes in Chinese subjects with IGT. CRP might provide an adjunctive measure for identifying subjects with the highest risk of progression to diabetes who would derive the greatest benefits from preventive interventions.

Abbreviations: apoB, apolipoprotein B • CRP, C-reactive protein • HOMA-IR, homeostasis model assessment index of insulin resistance • IGT, impaired glucose tolerance • NGT, normal glucose tolerance • OGTT, oral glucose tolerance test • WHO, World Health Organization


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