Title: Evaluation of C-Reactive Protein Levels amongst Patients of Diabetic Nephropathy in Rural Tertiary Care Centre of Central India
Authors: Devopam Roy, Manoj Kumar, Dheeraj Kela
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.36
Abstract
Background: Diabetes Mellitus is the most common endocrine disorder. The pathogenic vision of diabetes mellitus has changed in the last few years, with inflammatory pathways playing pivotal roles in the development and progression of diabetic complications. The present study was devised to find out the correlation between inflammatory markers and diabetic nephropathy.
Aim: To study the correlation between C-reactive protein and 24-hr urinary protein and Glycemic control in diabetic nephropathy patients.
Methods: A prospective observational study was done on 170 diabetic patients who were subjected to urine dipstick test for proteinuria. All those patients having positive dipstick proteinuria test were labeled as Macroalbuminuric diabetics. Dipstick Negative patients were subjected to 24 hours urine for microalbumin. Among these patients having 24 hour urine protein levels between 30-300 mg/24hrs were labelled as Microalbuminuric diabetic patients and less than 30 mg/24hrs were labelled as Normoalbuminuric diabetic patients. CRP levels and HbA1c were measured.
Results: The mean age were 52.26±6.28, 53.5±6.22, 52.9±6.04 in normoalbuminuric, microalbuminuric and macroalbuminuric patients. There were 56 females & 61 males in normoalbuminuric, 15 females & 15 males in microalbuminuric, 10 females & 13 males in macroalbuminuric patients. Mean years since detection of diabetes was 5.36±2.31, 9.10±2.61, 10.17±3.31 in normoalbuminuric, microalbuminuric and macroalbuminuric patients. Glycatedhemoglobin levels were 7.02±0.43, 8.32±0.86, 8.26±0.63 in 3 subsequent groups. Mean Urinary albumin excretion were 7.58±5.8, 188.9±64.9, 617.5±174.0 in 3 groups respectively. Mean levels of C- reactive protein were 1.91±0.975, 11.27±3.66, 12.57±3.58 in these 3 groups respectively. There was positive correlation found between urinary albumin excretion and C- reactive protein levels. Similarly, correlation of glycosylated hemoglobin with C-reactive protein and urinary albumin excretion was significantly positive.
Conclusion: We conclude from our study that there is a significant association between CRP levels and microalbuminuria in type 2 diabetes. Thus activation of inflammatory pathways in progression of kidney disease as represented by CRP can be useful for diagnosis of early stages of diabetic nephropathy.
Keywords-Diabetes Mellitus, C-Reactive Protein, Microalbuminuria, Nephropathy.
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