Inflammatory Markers are Associated with Microvascular Complications in Type 2 Diabetes

Background: Inflammatory markers are known to be sensitive predictors of atherosclerotic disease such as coronary heart disease.Diabetic patients have higher level of inflammatory markers such as fibrinogen, high sensitivity C-reactive protein (hsCRP) or IL-6.We investigated the association of inflammatory markers with microvascular complications in type 2 diabetes.Methods: We studied cross-sectionally 244 consecutive patients with type 2 diabetes without macrovascular disease such as cerebral infarct, coronary heart disease and peripheral arterial disease.The urinary albumin/creatinine ratio was determined in a morning, untimed, urine specimen.Ophthalmoscopic examinations were performed to evaluate diabetic retinopathy.Diabetic neuropathy was examined by 10-g monofilament, Neuropathic Disability Score and Michigan Neuropathy Screening Instrument.Results: 47 patients (23.5%) had diabetic retinopathy, 81 (34.6%) had nephropathy and 132 (54.2%) had neuropathy.Fibrinogen and erythrocyte sedimentation rate (ESR) were significantly higher in the patients with nephropathy, retinopathy and neuropathy than in those without (P = 0.009, 0.003 and 0.047; P = 0.011, 0.02 and 0.006 , respectively).There were no differences in the hsCRP and IL-6 level between in patients with microvascular complications and in those without.Inflammatory parameters were correlated with each other.The hsCRP was correlated with IL-6 (r = 0.40, P < 0.001) and fibrinogen (r = 0.45, P < 0.001), but fibrinogen was not significantly correlated with IL-6 (r = 0.13, P = 0.08). Conclusion:Although IL-6, hsCRP and fibrinogen may be associated with microvascular complications in type 2 diabetes, we show that fibrinogen is a strong marker of microvascular complications.(J Kor Diabetes Assoc 31:472~479, 2007)