Basil Bruno, Mohammed Jamila Aminu, Mba Izuchukwu Nnachi, Myke-Mbata Blessing Kenechi, Akujieze Joseph Chizoba
International Institute of Pathology and Forensic Science Research, David Umahi Federal University of Health Sciences, Uburu, Nigeria.
Department of Chemical Pathology, Nile University of Nigeria, Abuja, Nigeria.
BMC Cardiovasc Disord. 2025 Jul 9;25(1):498. doi: 10.1186/s12872-025-04975-3.
Cardiovascular disease (CVD) remains the leading cause of mortality in individuals with type 2 diabetes mellitus (T2DM), driven by chronic hyperglycaemia, dyslipidaemia, and systemic inflammation. In Nigeria, genetic predispositions, ethnic and environmental factors may further modulate CVD risk. This study aimed to evaluate the association between high-sensitivity C-reactive protein (hsCRP) and CVD risk in Nigerian T2DM patients receiving standard care.
This cross-sectional hospital-based study was conducted over 13 months. Data on socio-demographic characteristics, medical history, clinical findings, and laboratory parameters were collected using a structured proforma. Serum hsCRP was measured by homogenous immunoassay, while 10-year CVD risk was estimated with the WHO CVD risk assessment chart validated for Western sub-Saharan Africa. Statistical analyses, including binary logistic regression to assess the association between hsCRP and CVD risk, were conducted using SPSS version 25, with significance set at p < 0.05.
Moderate-to-high CVD risk was prevalent in 51.5% of the study population. Longer diabetes duration (AOR = 1.345, 95% CI: 1.222-1.480, p < 0.001), elevated HbA1c (OR = 1.438, 95% CI: 1.061-1.949, p = 0.019), and co-morbid hypertension (OR = 14.498, 95% CI: 2.611-80.515, p = 0.002) were significantly associated with higher CVD risk. Serum hsCRP levels were higher in moderate-to-high-risk individuals (median: 2.42 mg/L, IQR: 2.8; 2.71 mg/L, IQR: 1.8) compared to lower-risk individuals (median: 1.22 mg/L, IQR: 2.5; 1.48 mg/L, IQR: 2.6), p = 0.012. However, it was not an independent predictor of CVD risk after adjusting for confounders (p = 0.369).
There is a high burden of increased CVD risk in this population despite ongoing management, with prolonged diabetes duration, poor glycaemic control and co-morbid hypertension as key predictors. Although hsCRP levels were elevated in higher-risk individuals, its clinical utility as an independent predictor of CVD risk may be limited. These findings emphasize the need to strengthen routine CVD risk assessment, prioritize modifiable risk factors, and optimize glycaemic control to reduce CVD burden in Nigerian T2DM patients.
心血管疾病（CVD）仍然是2型糖尿病（T2DM）患者死亡的主要原因，由慢性高血糖、血脂异常和全身炎症驱动。在尼日利亚，遗传易感性、种族和环境因素可能进一步调节心血管疾病风险。本研究旨在评估接受标准治疗的尼日利亚T2DM患者中高敏C反应蛋白（hsCRP）与心血管疾病风险之间的关联。
这项基于医院的横断面研究进行了13个月。使用结构化表格收集社会人口学特征、病史、临床检查结果和实验室参数的数据。血清hsCRP通过均相免疫测定法测量，而10年心血管疾病风险则使用经撒哈拉以南非洲西部验证的世界卫生组织心血管疾病风险评估图表进行估计。使用SPSS 25版进行统计分析，包括二元逻辑回归以评估hsCRP与心血管疾病风险之间的关联，显著性设定为p < 0.05。
51.5%的研究人群中存在中度至高度心血管疾病风险。糖尿病病程较长（调整后比值比[AOR]=1.345，95%置信区间[CI]：1.222-1.480，p < 0.001）、糖化血红蛋白（HbA1c）升高（比值比[OR]=1.438，95% CI：1.061-1.949，p = 0.019）以及合并高血压（OR=14.498，95% CI：2.611-80.515，p = 0.002）与较高的心血管疾病风险显著相关。中度至高度风险个体的血清hsCRP水平（中位数：2.42mg/L，四分位间距[IQR]：2.8；2.71mg/L，IQR：1.8）高于低风险个体（中位数：1.22mg/L，IQR：2.5；1.48mg/L，IQR：2.6），p = 0.012。然而，在调整混杂因素后，它不是心血管疾病风险的独立预测因素（p = 0.369）。
尽管正在进行管理，但该人群中心血管疾病风险增加的负担仍然很高，糖尿病病程延长、血糖控制不佳和合并高血压是关键预测因素。虽然高风险个体的hsCRP水平升高，但其作为心血管疾病风险独立预测因素的临床效用可能有限。这些发现强调需要加强常规心血管疾病风险评估，优先考虑可改变的风险因素，并优化血糖控制以减轻尼日利亚T2DM患者的心血管疾病负担。
