High Sensitivity C-Reactive Protein and Tread Mill Test Responses in Patients with Type 2 Diabetes Mellitus

Abstract

Introduction: Patients with Type 2 Diabetes Mellitus (T2DM) are at an increased risk of Cardiovascular Disease (CVD) with >50% mortality risk. In cases where a resting Electrocardiograph (ECG) fails to detect the abnormal cardiac function, serum High-Sensitivity C-Reactive Protein (hsCRP) levels and Tread Mill Test (TMT) variables are prescribed independently for the CVD risk prediction. A possible link between TMT variables and underlying inflammation needs to be substantiated clinically. Aim: Evaluation of correlation between serum hsCRP levels and TMT variables in patients with T2DM. Materials and Methods: Over a period of three months, Thirty T2DM patients without clinical evidence of Coronary Artery Disease (CAD) were evaluated for complete haemogram, fasting and post prandial blood sugar, lipid profile, and serum hsCRP levels. Standard multistage maximal exercise test was conducted on a motorized treadmill according to Bruce protocol. Spearmen’s correlation coefficient was used for statistical analysis. Results: T2DM patients with higher serum hsCRP levels had lower exercise tolerance (r=-0.067; p=0.0001) and serum hsCRP levels increased with the duration of T2DM (r=0.55; p=0.002). Serum hsCRP levels and Heart Rate Recovery (HRR) at the end of first (r=-0.57) and second (r=-0.67) minute were statistically significant and showed negative correlation. Conclusion: The results suggested a possible role of inflammation in the stress test responses in patients with T2DM without overt heart disease. Incorporating both serum hsCRP levels and TMT for the assessment and evaluation of T2DM patients can improve the predictive risk for CVD.

Keywords

• cardiac autonomic neuropathy
• chronic hyperglycaemia
• exercise tolerance
• heart rate recovery
• inflammation