Serum high sensitivity C-reactive protein levels in metabolically healthy obese individuals versus lean type 2 Diabetes Mellitus patients

State of low-grade systemic inflammation is associated with obesity as well as T2DM. But not all obese develop T2DM and not all T2DM patients are obese. This paradox signifies that obesity is not sole determinant of its metabolic complications. The subset of obese individuals who are normotensive, normoglycemic having favorable lipid profile but excess adiposity is known as “Metabolically healthy obese”. C-reactive protein is an acute phase reactant protein synthesized by hepatocytes in response to several cytokines.

Study aimed to evaluate and compare levels of serum hsCRP in MHO (group I) and lean T2DM (group II) and controls (group III). In this case control study, we enrolled 50 lean patients of T2DM and 50 age and sex-matched MHO individuals. Demographic data, anthropometric measurements, BMI were recorded. After overnight fast, blood samples were collected and assayed for blood glucose, serum cholesterol, triglycerides, LDL, HDL, TG/HDL and hsCRP.

BMI was significantly higher in-group I (p =0.031) in comparison with group II and III. Blood sugar, TC, TG, LDL and hsCRP showed significant rise (p= 0.039, 0.024, 0.028, 0.0008 respectively) and HDL (p=0.027) was significantly decreased in group II while these values were normal in group I and III. Diabetic dyslipidemia was found in 64% (32 out of 50) of the cases. Significant positive correlation of hsCRP was observed with TG, LDL and TG/HDL (r=0.68, 0.69, 0.8, 0.81)while inverse correlation was seen with serum HDL (r=-0.74) in T2DM group.

Our study findings demonstrate adverse metabolic health of lean T2DM is more dangerous, proatherogenic than that of MHO individuals. Despite of low or normal body weight, T2DM group has unfavorable inflammatory status in comparison with metabolically healthy obesity.