Wednesday, March 17, 2010

C-Reactive Protein (CRP) - Marker of Inflammation

C-reactive protein (CRP) is the most common measurement of inflammation in the human body. It is increasingly being included in standard lab tests. Your doctor will realize that high CRP is associated with many chronic diseases, but may not be able to interpret your results.

Elevated CRP correlates very highly with the buildup of atherosclerotic plaque in the lining of blood vessels. CRP is a key indicator of the risk for heart disease and stroke. In recent years, prestigious medical journals like the Journal of the American Medical Association and the New England Journal of Medicine have published articles suggesting that CRP may be a more important indicator of heart disease risk than LDL cholesterol. Grabbing their cue from the latest research, pharmaceutical companies are now claiming that their patented statin drugs, which were originally marketed to lower LDL, can also effectively lower CRP.

If you suffer a serious injury or have an inflammatory disease like rheumatoid arthritis, your CRP will rise to very high levels -- perhaps in the hundreds. To measure chronic inflammation that is a coronary risk, your doctor will use the high sensitivity C-reactive protein (hs-CRP) which is designed to measure inflammation in the 0-10 range. Here are some reference ranges for hs-CRP:

0 - 0.5 mg/L ...... Low risk

0.5 - 3.0 mg/L ... Medium risk

> 3.0 mg/L ....... High risk

Lowering heart disease risk is critically important to diabetics who are regularly told that we have the same risk of a heart attack as somebody who has already suffered one heart attack. According to an article in the publication Diabetes Care in 2004, cardiovascular events in diabetic men were highly correlated with CRP. Those with CRP numbers in the upper quartile had three times as many heart attacks and cardiovascular events as those in the lower quartile.

There is more to the diabetic CRP story than heart disease. CRP correlates very highly with insulin resistance and measures of blood glucose control. A study at the Medical University of South Carolina published by ADA concluded that "the likelihood of elevated CRP concentrations increased with increasing HbA1c levels. These findings suggest an association between glycemic control and systemic inflammation in people with established diabetes." http://www.diabetesselfmanagement.com/articles/diabetes-definitions/c_reactive_protein/1/

According to limited studies, elevated CRP may also be predictive of the progression of diabetes and the development of diabetic complications like neuropathy and retinopathy. Research on CRP as a predictor of diabetic kidney disease, however, has been inconclusive.

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