Acute-phase proteins among patients with type 1 diabetes

Objective: To determine whether young type 1 diabetic patients without clinical microvascular or macrovascular complications have altered levels of acute-phase proteins (AFP), alpha(1)-acid glycoprotein (AGP), C-reactive protein (CRP) and fibrinogen and whether their AFP levels are related to glycemic control. Research Design and Methods: We studied cross-sectionally 48 type 1 diabetic outpatients (25 males) aged 19.9 +/- 9.8 years with a duration of diabetes of 5 (1-21) years, without clinical chronic complications and 66 non-diabetic subjects (26 males) aged 23.1 +/- 10.9 years. Inclusion criteria were normoalbuminuria, normal eye fundoscopy, and no evidence of cardiovascular disease or neuropathy. Results: High CRP [0.23 (0.01-2.90 I) vs (0.14 (0.01-2.41I) mg/dl p = 0.01] and AGP [53.5(40-78) vs 40.0(40-115) mg/dl p = 0.0001] levels were found in patients with type 1 diabetes compared to nondiabetic subjects. In the pooled group studied, AGP was correlated with CRP, HbA(1C), fasting plasma glucose (FBG) and AER and CRP was correlated with HbA(1C) and AER. The correlation of AGP and CRP with AER persisted after controlling for HbA(1C) and FBG. Stepwise multiple regression with AGP as the dependent variable showed that FBG and HbA(1C) were the significant independent variables. No correlation between AFP and HBA(1C) and FBG was observed in the diabetic group. Conclusions: According to our results, AFP, a known marker of low-grade chronic inflammation, are increased in patients with type 1 diabetes probably independently of glycemic control and the presence of clinical microvascular or macrovascular disease. The influence of AFP on the development of chronic complications in patients with type 1 diabetes must be addressed in prospective studies.