Association of acute-phase reactants with arterial stiffness in patients with type 2 diabetes mellitus

Background: The relationship between chronic low-grade inflammation and atherosclerotic progress in patients with diabetes mellitus has not been confirmed. We determined whether acute-phase reactants are associated with arterial stiffness in diabetic patients. Methods: Relationships of blood inflammatory markers [high-sensitivity C-reactive protein (CRP), amyloid A protein (SAA), sialic acid, fibrinogen and white blood cells (WBC)] with atherosclerosis were investigated in a cross-sectional study using 114 subjects with type 2 diabetes. The degree of atherosclerosis was evaluated by arterial stiffness measured using cardio-ankle vascular index (CAVI), a new index of arterial stiffness, which is compatible with conventional aortic pulse-wave velocity. Results: CRP, SAA, sialic acid, fibrinogen and WBC showed significant correlations with CAVI. CAVI was significantly higher in the highest tertile of sialic acid, fibrinogen and WBC compared with the lowest tertile or lowest and middle tertiles. This association was independent of age, sex and smoking. By logistic regression analysis, the highest levels of these acute-phase reactants showed increased risk of high CAVI, while CRP and SAA were not associated with an increased risk in this analysis. CAVI was also significantly correlated with duration of diabetes, blood pressure and serum total cholesterol. Conclusions: Acute-phase reactants, such as CRP, SAA, sialic acid, fibrinogen and WBC, are associated with arterial stiffness in patients with type 2 diabetes mellitus. (c) 2005 Elsevier B.V. All rights reserved.