What exactly is C-reactive protein (CRP)?

Have you heard about it? C-reactive protein level is an important factor in determining your risk of heart attack. It is made in our liver when inflammation is occurring somewhere in the body. Many medical conditions can cause inflammation resulting in elevated CRP including cancer, infection, coronary artery disease (which may itself lead to a heart attack), inflammatory bowel disease, autoimmune diseases, pneumonia and tuberculosis. Other conditions that cause CRP to rise include pregnancy, smoking, high blood pressure, and obesity. After surgery levels also rise. When a person responds to treatment for their condition, inflammation decreases and CRP will also decrease. Normal levels are 0-1.0 mg/dl.

High-sensitivity C-reactive protein (Hs-CRP) can be measured to evaluate if you are at a high risk for a heart attack. The risk levels are as follows:

High-sensitivity C-reactive Protein (Hs-CRP) Levels

Less than 1.0 mg/L Lowest risk
1.0 to 3.0 mg/L Average risk
More than 3.0 mg/L Highest risk

So this is very interesting, but what is the association between CRP and diabetes? Here are the facts:

1. Studies from India show an association between type 2 diabetes and elevated Hs-CRP.
2. A European study has pointed to CRP possibly predicting mortality in people with type 2 diabetes.
3. Many doctors now measure CRP if they suspect metabolic syndrome which may lead to diabetes and heart disease.
4. Individuals with a CRP greater than 3 mg/dl have a 4-6 times greater risk of developing type 2 diabetes than people with lower levels. This may be due to an increased amount of weight in the stomach area and it could also be attributed to heart disease.
5. When insulin resistance rises, so does CRP.
6. In type 1 young adults, high levels of HsCRP are associated with an increased risk of macular edema and retinal hard exudates. Macular edema is a serious problem that can contribute to vision loss. For more information on diabetic eye disease follow this link to the National Eye Institute

So now you understand what CRP is, how can you lower it if it is high?

1. Exercise: Ask your physician if you can start to exercise. What kind of exercise is recommended for you and how many minutes you should strive for.
2. If you smoke, stop: Find out what types of programs you may have in your area. If you still have a hard time ask your physician if there is a medication you can take to help you stop.
3. Use portion control at meal time: If you need to lose weight, work with your diabetes educator dietitian to work out a weight loss meal plan. Don’t eat gigantic meals (big meals cause inflammation and an increase in CRP).
4. Include adequate fiber in your diet: In a study published by the American Journal of Clinical Nutrition (Am J Clin Nutr. 2006 April; 83(4): 760–766.), a diet high in fiber is associated with lower CRP concentrations. This study recommends consuming 20-35 grams of dietary fiber per day.
5. Get your blood pressure under control: Lose weight if necessary and ask your physician what would be best to control your blood pressure.
6. Use medication prescribed by your physician as needed: Aspirin helps control inflammation and CRP. Statin drugs (taken to control cholesterol levels) also help. Have a discussion with your physician to see if you need these medications.

So control your inflammation and also your c-reactive protein. The steps you take to do this are healthy indeed!