Effects of Antidiabetic and Antihyperlipidemic Agents on C-Reactive Protein

Dandona, Paresh
March 2008
Mayo Clinic Proceedings;Mar2008, Vol. 83 Issue 3, p333
Academic Journal
Type 2 diabetes mellitus (DM) increases the risk of cardiovascular disease, a major cause of morbidity and mortality. Central to type 2 DM is insulin resistance, a proinflammatory, hypercoagulable state that predisposes patients to develop cardiovascular disease and that is associated with risk factors for atherosclerosis including dyslipidemia, hypertension, inflammation, and altered hemostasis. Atherosclerosis is recognized as a chronic inflammatory disease of the arteries. C-reactive protein (CRP) is an acute-phase response protein that is considered both a marker of inflammation and a predictor of cardiovascular events including myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death. Evidence indicates that CRP has a direct proatherogenic effect through up-regulation of angiotensin II type 1 receptors and through the stimulation of other proinflammatory factors. Patients with type 2 DM tend to have higher CRP concentrations than do those without it, suggesting an increased role of inflammation in the accelerated atherosclerosis seen in these patients. Reducing CRP concentrations through lifestyle changes or pharmacotherapeutics could have clinical benefit; long-term studies are needed to determine whether reductions in CRP concentrations translate into improved cardiovascular outcomes. Because glucose and lipid levels as well as CRP concentrations are often elevated in patients with type 2 DM, an agent that positively affects multiple cardiovascular risk factors would be most beneficial. This article reviews available data on antidiabetic and antihyperlipidemic agents that reduce CRP concentrations in addition to their primary effect of lowering glucose or lipid levels.


Related Articles

  • Lipoprotein (a), C-reactive protein and some metabolic cardiovascular risk factors in type 2 DM. Ogbera, Anthonia O.; Azenabor, Alfred O. // Diabetology & Metabolic Syndrome;2010, Vol. 2 Issue 1, p1 

    Background: Lipoprotein (a) (LP (a) is an independent cardiovascular risk factor that is not widely studied in people of sub-Saharan African origin. The aim of this report is to determine the frequency of occurrence of elevated Lp (a) and possible relationship with total cholesterol (TCHOL),...

  • Pramlintide, as an Adjunct to Basal Insulin, Reduced C-Reactive Protein, Improved Glycemic Control, and Led to Weight Loss in Patients With Type 2 Diabetes. Lush, Cameron; Frias, Juan; Bei Zhang; Maier, Holly; Kolterman, Orville // Diabetes;Jun2007 Supplement 1, Vol. 56, pA144 

    Cardiovascular disease (CVD) is a major cause of morbidity and mortality in patients with type 2 diabetes (T2DM). Elevated high-sensitivity C-reactive protein (hsCRP) has been reported as a marker of increased risk of CVD. The effects of pramlintide (PRAM; 60 or 120 µg with major meals) on...

  • Effect of Pioglitazone vs Metformin on Cardiovascular Risk Markers in Type 2 Diabetes: Results of a Double Blind, Randomized Study. Evangelista, Virgilio; Ceriello, Antonio; De Berardis, Giorgia; Pellegrini, Fabio; Totani, Licia; Di Pietro, Cinzia; Bellatreccia, Andrea; Nicolucci, Antonio // Diabetes;Jun2007 Supplement 1, Vol. 56, pA580 

    Besides its critical role in metabolic homeostasis, PPAR-γmodulates a variety of cellular responses playing a key role in atherothrombosis. This multicenter, double blind, randomized study investigated the effects of pioglitazone on markers of inflammation, platelets' activation,...

  • Rosiglitazone Decreases C-Reactive Protein (CRP) Relative to Glyburide and Metformin over Four-Years in Spite of Greater Weight Gain. Haffner, Steven M.; Kahn, Steven E.; Zinman, Bernard; Holman, Rury R.; Viberti, Giancarlo F.; Herman, William H.; Lachin, John M.; Kravitz, Barbara G.; Heise, Mark A. // Diabetes;Jun2007 Supplement 1, Vol. 56, pA176 

    In A Diabetes Outcomes Progression Trial (ADOPT), rosiglitazone (RSG) was shown to decrease progression to monothempy failure relative to glyburide (GLY) and metformin (MET) in recently diagnosed type 2 diabetic patients. We previously reported that obesity at baseline was the main determinant...

  • Effect to Carotid Intima-Media Thickness in Type 2 Diabetic Patients After Pioglitazone 15mg Therapy. Minho Cho; Jae-Myung Yu; Jun Goo Kang; Jong-Suk Park; Byung Wan Lee; Sung-Jin Lee; Chul-Sik Kim; Chul Woo Ahn; Young Duk Song; Eun-Gyoung Hong; Hyunkyu Kim; Doo-Man Kim; Sunghee Ihm; Kyung Rae Kim; Munki Choi; Hyung-Joon Yoo // Diabetes;Jun2007 Supplement 1, Vol. 56, pA554 

    Background: Carotid intima-media thickness (cIMT) is a strong predictor of macrovascular disease. Pioglitazone has been reported to have antiatherogenic effect and anti-inflammatory effect. But the dose of pioglitazone in previous clinical trial was 30mg or 45 mg daily. This study was performed...

  • IRIS V-Study: Pioglitazone Reduces High-Sensitivity CRP Values in Patients with Type 2 Diabetes Under Daily Routine Conditions. Pfützner, Andreas; Schöndorf, Thomas; Lübben, Georg; Flannery, Manja; Grabellus, Martin; Roth, Werner; Forst, Thomas; Karagiannis, Efstrathios // Diabetes;Jun2007 Supplement 1, Vol. 56, pA586 

    Type 2 diabetes mellitus is associated with several cardiovascular risk factors including postprandial glucotoxicity and a chronic vascular inflammation. With respect to the latent inflammation, the most reliable and accessible marker currently available for clinical use is high-sensitive...

  • Inflammation, Insulin Resistance, and DiabetesMendelian Randomization Using CRP Haplotypes Points Upstream. Brunner, Eric J.; Kivimki, Mika; Witte, Daniel R.; Lawlor$2, Debbie A.; Smith, George Davey; Cooper, Jackie A.; Miller, Michelle; Lowe, Gordon D. O.; Rumley, Ann; Casas, Juan P.; Shah, Tina; Humphries, Steve E.; Hingorani, Aroon D.; Marmot, Michael G.; Timpson, Nicholas J.; Kumari, Meena // PLoS Medicine;Aug2008, Vol. 5 Issue 8, pe155 

    Using a Mendelian randomization approach, Eric Brunner and colleagues show that the associations between serum C-reactive protein and insulin resistance, glycemia, and diabetes are likely to be noncausal.

  • C-Reactive Protein and 5-Year Survival in Type 2 Diabetes. Bruno, Graziella; Fornengo, Paolo; Novelli, Giulia; Panero, Francesco; Perotto, Massimo; Segre, Olivia; Zucco, Chiara; Deambrogio, PierCarlo; Bargero, Giuseppe; Perin, Paolo Cavallo // Diabetes;Apr2009, Vol. 58 Issue 4, p926 

    OBJECTIVE--To determine to what extent plasma C-reactive protein (CRP) values influence 5-year all-cause and cardiovascular mortality in type 2 diabetic individuals, independently of albumin excretion rate (AER) and other cardiovascular risk factors, and its incremental usefulness for predicting...

  • Interleukin-6 gene promoter polymorphisms and cardiovascular risk factors. A family study. Guzmán-Guzmán, Iris Paola; Muñoz-Valle, José Francisco; Flores-Alfaro, Eugenia; Salgado-Goytia, Lorenzo; Salgado-Bernabé, Aralia Berenice; Parra-Rojas, Isela // Disease Markers;2010, Vol. 28 Issue 1, p29 

    Interleukin-6 (IL-6) is a cytokine involved in inflammatory process, as well as in glucose and lipid metabolism. Several studies of the biological relevance of IL-6 gene polymorphisms have indicated a relationship with cardiovascular disease. The aim of this study was to assess whether the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics