Association of high sensitivity C-reactive protein [hsCRP] and Tumour Necrosis Factor- α [TNF-α] with carotid Intimal Medial Thickness in subjects with different grades of glucose intolerance- The Chennai Urban Rural Epidemiology Study (CURES- 63)

Abstract

Objective: To assess the association of high sensitivity C-Reactive Protein [hsCRP] and Tumour Necrosis Factor-α [TNF-α] with IMT in Asian Indians with different grades of glucose intolerance. Design and methods: Subjects with normal glucose tolerance [NGT](n=150), impaired glucose tolerance [IGT] (n=150) and type 2 diabetes (DM) (n=150) were recruited from the Chennai Urban Rural Epidemiology Study [CURES], in south India. hsCRP was estimated by nephelometry and TNF-α by enzyme linked immunosorbent assay. Carotid IMT was assessed by high resolution B-mode ultrasonography. Results: hsCRP and TNF-α levels were higher in those with DM [pb0.001] and IGT [pb0.001] compared to NGT. In linear regression analysis, both hsCRP [p=0.003] and TNF-α [p=0.001] showed an association with IMT among NGT subjects even after adjusting for age and gender. Among IGT subjects, TNF-α was associated with IMT [pb0.001], while no association was observed either with hsCRP or TNF-α in diabetic subjects. In NGT subjects, mean IMT was highest in those with high values [III tertile] of both TNF-α and hsCRP [0.83±0.1 mm; pb0.001] followed by those with high TNF-α+low hsCRP [0.74±0.09 mm; pb0.001], high hsCRP low TNF-α [0.67±0.09 mm; pb0.001], and lowest in those with both low TNF-α and hsCRP [I tertile] [0.63±0.05 mm. Conclusion: We conclude that in Asian Indians 1. Levels of hsCRP and TNF-α increase with increasing severity of glucose intolerance 2. Both hsCRP and TNF-α are associated with IMT in NGT subjects while TNF-α alone is associated with IMT in IGT subjects 3. hsCRP and TNF-α have a cumulative effect on mean IMT values in NGT subjects. © 2008 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.