Changing correlations among ADMA, NO and hs-CRP in normoalbuminuric and microalbuminuric patients with type 2 diabetes

- Diabetic type 2 Patients with microalbuminuria had higher hs-CRP and ADMA/NO ratio than normoalbuminuric group.
- While there was a positive correlation between ADMA and NO, and also between ADMA and CRP in the normoalbuminuric group, these correlations were lost in microalbuminuric state.
- On the contrary a positive correlation appeared between NO and CRP in microalbuminuric group which there was not in normoalbuminuric group.

BackgroundAlbuminuria is one of the first asymptomatic clinical manifestations of microvascular damage in type 2 diabetes. High-sensitivity C-reactive protein (hs-CRP), Asymmetric dimethylarginine (ADMA), and nitric oxide (NO) are important risk factors for endothelial dysfunction. The aim of this study is to evaluate hs-CRP, ADMA, and NO levels and their correlations in patients with type 2 diabetes respect to their albuminuric states.MethodsWe quantified serum hs-CRP, ADMA, and NO levels in 40 microalbuminuric (urinary albumin excretion ≤ 30 mg/day and < 300 mg/day) type 2 diabetic patients and 40 age, gender, and body mass index (BMI)-matched normoalbuminuric (urinary albumin excretion < 30 mg/day) diabetic patients in this case-control study.ResultsThe mean value of albuminuria was 238 ± 58 mg/day in the microalbuminuric group and 12.6 ± 4.7 mg/day in the normoalbuminuric group. Creatinine was significantly higher and GFR was significantly lower in group with microalbuminuria than normoalbuminuria (p < 0.05). Albuminuric diabetic patients had significantly higher hs-CRP levels as compared to normoalbuminuric group (3.9 ± 0.8 mg/dL versus 5.7 ± 1.4 mg/dL, p < 0.05). However there were no significant differences in ADMA and NO between two groups but the ADMA/NO ratio was significantly higher in albuminuric group comparing with normoalbuminuric one (0.017 vs. 0.015, p value < 0.05). In control group (normoalbuminuria) age, gender and BMI-adjusted ADMA indicated a significant and positive correlation with NO (r = 0.430, p value = 0.022) and with hs-CRP (r = 0.362, p value = 0.041), and also a significant and positive correlation was found between hs-CRP and NO in case group (with microalbuminuria) (r = 0.370, p value = 0.026).ConclusionHs-CRP was higher in microalbuminuric patients with type 2 diabetes compare to normoalbuminuric group. Also we found changing association among ADMA, NO and hs-CRP from normoalbuminuric to albuminuric state which this finding may be linked to the role of basic inflammation in confounding some interactions and creating some new ones.