Publication:

Serum alkaline phosphatase and high sensitivity C-reactive protein in type II diabetes mellitus: a risk of cardio vascular disease in South Indian population

Background Diabetes mellitus (DM) is a clinical syndrome characterized by abnormal metabolism of carbohydrate, protein and fat resulting in hyperglycemia due to absolute or relative deficiency of insulin ending up in vascular complications leading to retinopathy, neuropathy and nephropathy. The aim of the study was to examine the relationship between alkaline phosphatase (ALP) and high sensitive C reactive protein (hsCRP), in type 2 diabetic patients. We assessed the association of ALP and hsCRP levels with CVD complication and determined its utility for CVD risk prediction in type 2 DM subjects with good and poor glycemic control. Further, we investigated correlation between serum ALP and hsCRP level with glycemic control (FBS, PP2BS, HbA1c) in subjects.

Methods A cross sectional study consists of 390 patients out of which 100 normal healthy control (Group I) , 120 patients having type 2 DM with good control (Group II), 170 patients with type 2 DM with poor control (Group III) were selected. Serum ALP, serum hsCRP, FBS, PP2BS, HbA1c, and other biochemical investigations including serum liver enzymes and lipid profile were measured.

Results In Study I Mean serum ALP(145.17±23.91) and hsCRP (2.53±0.76) concentration in group II patients when compared to group I serum ALP(142.17±16.48) and Hscrp (1.51±0.15) shows a significance of ALP (p<0.05) and Hscrp (p<0.001).Study II Mean serum ALP(145.17±23.91) and hsCRP (2.53±0.76) concentration in group II patients when compared to group III serum ALP (147.79±28.95) and Hscrp (3.848±0.47) group shows a significance of ALP (p<0.001) and Hscrp (p<0.05). Study III Mean serum ALP (147.79±28.95) and hsCRP (3.848± 0.47) concentration in group III patients when compared to group I serum ALP (142.17±16.48) and Hscrp (1.51±0.15) shows a high significance of both ALP and Hscrp (p<0.001). Further significant positive correlation was observed between ALP and hsCRP concentration as well as with HbA1c, FBS, and PP2BS.

Conclusions Inflammation along with the poor glycemic control in diabetes play a role in diabetic macrovascular complication like CVD. All these finding are showing a link between CVD, inflammation and glycemic control in patient with type 2 diabetes mellitus.