Journal List > J Korean Diabetes Assoc > v.31(6) > 1062475

Yang, Kim, Lee, Kim, Nam, and Park: Inflammatory Markers are Associated with Microvascular Complications in Type 2 Diabetes



Inflammatory markers are known to be sensitive predictors of atherosclerotic disease such as coronary heart disease. Diabetic patients have higher level of inflammatory markers such as fibrinogen, high sensitivity C-reactive protein (hsCRP) or IL-6. We investigated the association of inflammatory markers with microvascular complications in type 2 diabetes.


We studied cross-sectionally 244 consecutive patients with type 2 diabetes without macrovascular disease such as cerebral infarct, coronary heart disease and peripheral arterial disease. The urinary albumin/creatinine ratio was determined in a morning, untimed, urine specimen. Ophthalmoscopic examinations were performed to evaluate diabetic retinopathy. Diabetic neuropathy was examined by 10-g monofilament, Neuropathic Disability Score and Michigan Neuropathy Screening Instrument.


47 patients (23.5%) had diabetic retinopathy, 81 (34.6%) had nephropathy and 132 (54.2%) had neuropathy. Fibrinogen and erythrocyte sedimentation rate (ESR) were significantly higher in the patients with nephropathy, retinopathy and neuropathy than in those without (P = 0.009, 0.003 and 0.047; P = 0.011, 0.02 and 0.006 , respectively). There were no differences in the hsCRP and IL-6 level between in patients with microvascular complications and in those without. Inflammatory parameters were correlated with each other. The hsCRP was correlated with IL-6 (r = 0.40, P < 0.001) and fibrinogen (r = 0.45, P < 0.001), but fibrinogen was not significantly correlated with IL-6 (r = 0.13, P = 0.08).


Although IL-6, hsCRP and fibrinogen may be associated with microvascular complications in type 2 diabetes, we show that fibrinogen is a strong marker of microvascular complications.

Figures and Tables

Table 1
Basal characteristics of type 2 diabetes

BMI, body mass index; ACE inhibitors, angiotensin-converting enzyme inhibitors.

Table 2
Inflammatory markers and clinical data of type 2 diabetic patients with and without retinopathy

Data are mean ± SD or %. BMI, body mass index; HDL, high density lipoprotein; LDL, low density lipoprotein; hsCRP, high sensitivity C-reactive protein.

Table 3
Inflammatory markers and clinical data of type 2 diabetic patients with and without nephropathy

Data are mean ± SD or %. BMI, body mass index; HDL, high density lipoprotein; LDL, low density lipoprotein; hsCRP, high sensitivity C-reactive protein.

Table 4
Inflammatory markers and clinical data of type 2 diabetic patients with and without neuropathy

Data are mean ± SD or %. BMI, body mass index; HDL, high density lipoprotein; LDL, low density lipoprotein; hsCRP, high sensitivity C-reactive protein.

Table 5
Logistic regression model with microvascular complications as dependent variables

SBP, systolic blood pressure.

Table 6
Correlation coefficients of fibrinogen, hsCRP and IL-6 with anthropometric, clinical and metabolic parameters

ACR, urinary albumin to creatinine ratio; BMI, Body mass index; WBC, white blood cell.


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