The prevalence of positive C-reactive protein and elevated erythrocyte sedimentation rate among individuals with type 2 diabetes mellitus and non-alcoholic fatty liver disease

Chronic inflammation plays a central role in both type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). This study evaluated the association of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) among patients with T2DM, NAFLD, and concurrent disease. In this cross-sectional study, 150 participants were equally divided into three groups: T2DM or NAFLD, and concurrent T2DM and NAFLD. Demographic and clinical data were recorded, and CRP and ESR levels were measured. Statistical analyses included ANOVA, Kruskal–Wallis, Chi-square tests, and logistic regression models adjusted for age and gender by reporting odds ratios (ORs) and 95% confidence intervals (CIs). A p-value <0.05 was considered statistically significant. ESR levels differed significantly among groups (p <0.001), with the highest values observed in the T2DM+NAFLD group. Adjusted logistic regression showed that patients with T2DM+NAFLD had a 3.8-fold increased odds of elevated ESR compared to NAFLD alone (95% CI: 1.345–10.759, p=0.012). CRP positivity did not significantly differ between groups; however, categorical CRP analysis revealed significant distribution differences (p <0.001). Coexistence of T2DM and NAFLD is associated with greater systemic inflammatory burden, particularly reflected by elevated ESR. ESR may serve as a more sensitive inflammatory marker than CRP in patients with combined metabolic disorders.