1.The Level of N-Carboxymethyllysine and C-Reactive Protein in Type 2 Diabetes Mellitus and it’s Association with HbA1c in Diabetic Nephropathy
Mohd Zulhafiz Mat Rahim ; Wan Norlina Wan Azman ; Najib Majdi Yaacob ; Wan Mohd Izani Wan Mohamed ; Noorazliyana Shafii
Malaysian Journal of Medicine and Health Sciences 2023;19(No.4):282-289
Introduction: N-Carboxymethyllysine (CML) is involved in diabetic nephropathy (DN) via production of oxidative
stress, growth factors and cytokines. C-reactive protein (CRP) is an inflammatory marker associated with diabetes
risk. This study is to determine the level of serum CML and CRP in Type 2 diabetes mellitus (T2DM) patients and
healthy subjects and to determine the correlation between CML and CRP with glycated haemoglobin (HbA1c) in
T2DM patients. Methods: This is a case-control study on 73 T2DM patients without nephropathy, 74 T2DM patients
with nephropathy and 73 healthy subjects, aged from 18 to 65 years old. Fasting venous blood was taken and analysed for CML, CRP, HbA1c, and creatinine. The comparisons of serum CML and CRP among the three groups and
the correlation between CML and CRP with HbA1c (in T2DM patients) were determined. Results: The differences in
CML [median (Interquartile Range) (IQR)] between healthy subjects [131.80 (73.56) ng/ml] and T2DM patients without nephropathy [188.80 (55.95) ng/ml]; between healthy subjects and T2DM patients with nephropathy [237.70
(439.04) ng/ml] were statistically significant (P<0.001). The differences in CRP [median (IQR)] between healthy
subjects [1.64 (1.91) ng/ml] and T2DM patients without nephropathy [2.15 (5.64) ng/ml]; between healthy subjects
and T2DM patients with nephropathy [4.75 (6.91) ng/ml] were statistically significant (P<0.001). Logistic regression
showed CML and CRP are independent predictors of diabetic groups. There was no correlation between HbA1c with
CML and CRP in T2DM groups. Conclusion: Since serum CML and CRP are independent predictors of DN, their
levels can be used to identify high-risk diabetic patients prone to developing DN.