Serum C-reactive protein and C-reactive protein derived markers in diabetic microvascular complications

Abstract

Chronic low-grade inflammation is a major contributor to both the onset and advancement of type 2 diabetes mellitus (T2DM), and its associated microvascular complications, including diabetic nephropathy, retinopathy, and peripheral neuropathy. This review aims to overview the roles of high sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP), CRP-to-lymphocyte count ratio (CLR), and the CRP-to-albumin ratio (CAR) as biomarkers for assessing systemic inflammation and predicting the development and severity of diabetic chronic microvascular complications. Elevated levels of CRP and hs-CRP have been consistently associated with increased risk of these complications, reflecting ongoing inflammatory processes that contribute to endothelial dysfunction and tissue damage. Furthermore, CAR and CLR, which combine CRP with albumin and lymphocyte counts respectively, offer a more nuanced understanding of the inflammatory and immune response in T2DM patients. While individual studies have demonstrated the clinical relevance of these biomarkers in predicting disease onset and progression, further investigation is needed to establish their utility in clinical practice. This review highlights the potential of these biomarkers for enhancing early detection, risk stratification, and personalized management of diabetic patients, ultimately aiming to improve outcomes and reduce the burden of diabetic chronic microvascular complications.

Keywords: Inflammation; C-reactive protein; C-reactive protein to albumin ratio; C-reactive protein to lymphocyte count ratio; Type 2 diabetes mellitus

Core Tip: Type 2 diabetes mellitus (T2DM) is a chronic condition marked by high blood glucose, insulin resistance, and chronic inflammation. It is often accompanied by severe complications and systemic inflammation. Recent research highlighted C-reactive protein (CRP) and CRP derived markers such as high sensitivity-CRP, CRP-to-albumin ratio, and CRP-to-lymphocyte count ratio, as valuable tools for predicting the onset, progression, and complications of T2DM and diabetic microvascular complications. These markers are easily accessible through blood tests and serum biochemistry. They provide important data into inflammation and vascular changes linked to T2DM, including neuropathy, nephropathy, and retinopathy.