Abstract

In this study, we wanted to evaluate the correlation between levels of acute phase reactants (serum CRP, serum fibrinogen) and severity of albuminuria in patients with type 2 diabetes mellitus. Material and Methods: This was a hospital based observational study conducted among 100 patients who presented with type 2 diabetes mellitus to the Institute of Internal Medicine, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, over a period of 6 months after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. Results: HbA1c correlates with excretion of albumin with a p value of 0.001. Higher albumin excretion rates are associated with higher levels of Sr. Fibrinogen (p value = 0.001) Albuminuria grade correlates with serum creatinine values (p value = 0.001). Micro albuminuria and macro albuminuria are associated with higher levels of CRP when compared to the normoalbuminuric patients. Serum fibrinogen is elevated in overt and macro albuminuric groups than normoalbuminuric group. Micro and macro albuminuric groups are noted to have higher HbA1c levels than the normoalbuminuric group, implying that a tighter glycemic control can reduce the risk of nephropathy. Conclusion: Higher HbA1c and longer duration of diabetes can lead to more severe nephropathy. Thus, a poor glycemic control predicts greater degrees of nephropathy. Acute phase reactants namely serum CRP and serum fibrinogen are elevated in diabetic nephropathy, suggesting that it is an inflammatory state. Hence, serum CRP and fibrinogen may be used as predictors of nephropathy in diabetic patients.

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