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-31)

Objective: To assess the association of high sensitivity C-Reactive Protein [hsCRP] and Tumour Necrosis Factor-alpha [TNF-alpha] 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-a by enzyme linked immunosorbent assay. Carotid IMT was assessed by high resolution B-mode ultrasonography. Results: hsCRP and TNF-alpha levels were higher in those with DM [p<0.001] and IGT [p<0.001] compared to NGT. In linear regression analysis, both hsCRP [p=0.003] and TNF-alpha [p=0.001] showed an association with IMT among NGT subjects even after adjusting for age and gender. Among IGT subjects, TNF-a was associated with IMT [p<0.001], while no association was observed either with hsCRP or TNF-alpha in diabetic subjects. In NGT subjects, mean IMT was highest in those with high values [111 tertile] of both TNF-a and hsCRP [0.83 +/- 0.1 mm;p<0.001] followed by those with high TNF-alpha+low hsCRP [0.74 +/- 0.09 mm;p<0.001], high hsCRP low TNF-alpha[0.67 +/- 0.09 mm;p<0.001], and lowest in those with both low TNF-alpha and hsCRP [I tertile] [0.63 +/- 0.05 mm. Conclusion: We conclude that in Asian Indians 1. Levels of hsCRP and TNF-alpha increase with increasing severity of glucose intolerance 2. Both hsCP,P and TNF-alpha are associated with IMT in NGT subjects while TNF-alpha alone is associated with IMT in IGT subjects 3. hsCRP and TNF-alpha have a cumulative effect on mean IMT values in NGT subjects. (c) 2008 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.