Clinical significance of detection of serum C-reactive protein-fasting C-peptide product, remnant cholesterol and 25-hydroxyvitamin D in type 2 diabetes mellitus

Abstract

C-reactive protein (CRP) and fasting C-peptide (FCP) have been determined together by various publications to assess cardiovascular risk and metabolic health, particularly in relation to insulin resistance and type 2 diabetes mellitus (T2DM). CRP-FCP product may provide a more comprehensive assessment of the cardiovascular risk burden than CRP or FCP alone in patients with T2DM. Remnant cholesterol (RC) is an independent predictor of cardiovascular events in people with T2DM. The detection of RC should be regarded as a complementary marker for diabetes risk stratification rather than a replacement for triglycerides, especially in individuals with relatively low baseline metabolic risk. Low 25-hydroxyvitamin D (25[OH]D) levels common in T2DM, are also strongly linked with increased cardiovascular disease risk. In euthyroid adults with T2DM, higher 25[OH]D is associated with a higher free triiodothyronine-to-free thyroxine ratio, mainly at low 25[OH]D levels. In conclusion, elevated levels of CRP-FCP product and RC and low levels of 25[OH]D “in combination” are strong promising and emerging predictors for T2DM and for cardiovascular disease and other complications in T2DM. This editorial highlights the clinical significance of detection of serum CRP-FCP product, RC and 25[OH]D in T2DM in light of the recent studies of Zhu et al, Jun et al and Zhang et al published in the World Journal of Diabetes.

Keywords: C-reactive protein; Fasting C-peptide; 25-hydroxyvitamin D; Type 2 diabetes mellitus; Cardiovascular risk

Core Tip: The elevated levels of C-reactive protein and fasting C-peptide product and remnant cholesterol and the low levels of 25-hydroxyvitamin D in combination are strong promising and emerging predictors for type 2 diabetes mellitus and for cardiovascular disease and other complications in type 2 diabetes mellitus. This integrative approach allows for better identification of high-risk patients, more accurate prognosis forecasting, and tailored therapeutic strategies.