Association between C reactive protein and microvascular and macrovascular dysfunction in sub-Saharan Africans with and without diabetes: The RODAM study

Charles Frederick Hayfron-Benjamin, Anke H. Maitland-van der Zee, Bert-Jan van den Born, Albert G. B. Amoah, Karlijn A. C. Meeks, Kerstin Klipstein-Grobusch, Matthias B. Schulze, Joachim Spranger, Ina Danquah, Liam Smeeth, Erik J. A. J. Beune, Frank Mockenhaupt, Charles O. Agyemang

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9 Citations (Scopus)

Abstract

Introduction Although inflammation assessed by elevated C reactive protein (CRP) concentration is known to be associated with risk of cardiovascular disease, its association with microvascular and macrovascular dysfunction in diabetes and non-diabetes remains unclear. We examined the association between CRP and diabetes and associated microvascular and macrovascular dysfunction in sub-Saharan Africans with and without diabetes. Research design and methods Cross-sectional analyses of baseline data from the multicenter RODAM study (Research on Obesity and Diabetes among African Migrants) including 5248 Ghanaians (583 with diabetes, 4665 without diabetes) aged 25-70 years were done. Logistic regression analyses were used to examine the associations between CRP Z-scores and diabetes and microvascular (nephropathy) and macrovascular (peripheral artery disease (PAD)) dysfunction, with adjustments for age, sex, site of residence, smoking, body mass index, systolic blood pressure, and low-density lipoprotein cholesterol. Results In the fully adjusted models, higher CRP concentration was significantly associated with diabetes (adjusted OR 1.13; 95% CI 1.05 to 1.21, p=0.002). In participants with diabetes, higher CRP concentration was associated with PAD (1.19; 1.03 to 1.41, p=0.046) but not nephropathy (1.13; 0.97 to 1.31, p=0.120). Among participants without diabetes, higher CRP concentration was associated with higher odds of PAD (1.10; 1.01 to 1.21, p=0.029) and nephropathy (1.12; 1.04 to 1.22, p=0.004). Conclusions In this study, higher CRP concentration was associated with higher odds of diabetes in sub-Saharan Africans. Also, higher CRP concentration was associated with higher odds of nephropathy and PAD in non-diabetes and higher odds of PAD in diabetes. CRP may be an important marker for assessment of risk of diabetes and risk for PAD and nephropathy in sub-Saharan Africans with and without diabetes.
Original languageEnglish
Article numbere001235
JournalBMJ open diabetes research and care
Volume8
Issue number1
DOIs
Publication statusPublished - 14 Jul 2020

Keywords

  • C-reactive protein
  • adult diabetes
  • inflammation
  • microvascular and macrovascular complications

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