Plasma C-Reactive Protein Levels in Severe Diabetic Ketoacidosis

Rory R. Dalton, William H. Hoffman, Gregory G Passmore, S. Lee Anne Martin

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Elevated plasma levels of C-reactive protein (CRP) and IL-6 have been reported to be sensitive indicators of infection in adults with diabetic ketoacidosis (DKA). However, both CRP and the proinflammatory cytokines, which regulate CRP, can be elevated without infection. Our hypothesis was that CRP is increased in young patients with severe DKA, even in the absence of an infection, and may serve as a marker for systemic inflammatory response syndrome (SIRS). In 7 patients with severe DKA without infection, we measured plasma CRP, IL-6, IL-1β and TNF-α levels prior to, during, and following correction of DKA. CRP was significantly but transiently elevated in 4 of the patients prior to or during treatment of DKA, compared to their baseline values (96 hr after correction of DKA). There were significant positive relationships between CRP and both IL-6 and IL-1β prior to treatment (p <0.05); between CRP and IL-6, IL-1β, and TNF-α at 6 hr (p <0.05); and between CRP and IL-1β at 24 hr (p <0.05). The results support the hypothesis that CRP is increased in some patients by severe DKA and its treatment, and that DKA can be associated with a non-infectious form of SIRS.

Original languageEnglish (US)
Pages (from-to)435-442
Number of pages8
JournalAnnals of Clinical and Laboratory Science
Volume33
Issue number4
StatePublished - Sep 1 2003

Fingerprint

Diabetic Ketoacidosis
C-Reactive Protein
Blood Proteins
Plasmas
Interleukin-1
Interleukin-6
Systemic Inflammatory Response Syndrome
Infection
Therapeutics
Cytokines

Keywords

  • C-reactive protein
  • Cytokines
  • Diabetic ketoacidosis
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Microbiology
  • Immunology and Allergy
  • Pathology and Forensic Medicine
  • Immunology
  • Molecular Biology
  • Hematology
  • Clinical Biochemistry
  • Medical Laboratory Technology

Cite this

Plasma C-Reactive Protein Levels in Severe Diabetic Ketoacidosis. / Dalton, Rory R.; Hoffman, William H.; Passmore, Gregory G; Martin, S. Lee Anne.

In: Annals of Clinical and Laboratory Science, Vol. 33, No. 4, 01.09.2003, p. 435-442.

Research output: Contribution to journalArticle

Dalton, Rory R. ; Hoffman, William H. ; Passmore, Gregory G ; Martin, S. Lee Anne. / Plasma C-Reactive Protein Levels in Severe Diabetic Ketoacidosis. In: Annals of Clinical and Laboratory Science. 2003 ; Vol. 33, No. 4. pp. 435-442.
@article{a1df68155b93450b96ce41b6d13d9626,
title = "Plasma C-Reactive Protein Levels in Severe Diabetic Ketoacidosis",
abstract = "Elevated plasma levels of C-reactive protein (CRP) and IL-6 have been reported to be sensitive indicators of infection in adults with diabetic ketoacidosis (DKA). However, both CRP and the proinflammatory cytokines, which regulate CRP, can be elevated without infection. Our hypothesis was that CRP is increased in young patients with severe DKA, even in the absence of an infection, and may serve as a marker for systemic inflammatory response syndrome (SIRS). In 7 patients with severe DKA without infection, we measured plasma CRP, IL-6, IL-1β and TNF-α levels prior to, during, and following correction of DKA. CRP was significantly but transiently elevated in 4 of the patients prior to or during treatment of DKA, compared to their baseline values (96 hr after correction of DKA). There were significant positive relationships between CRP and both IL-6 and IL-1β prior to treatment (p <0.05); between CRP and IL-6, IL-1β, and TNF-α at 6 hr (p <0.05); and between CRP and IL-1β at 24 hr (p <0.05). The results support the hypothesis that CRP is increased in some patients by severe DKA and its treatment, and that DKA can be associated with a non-infectious form of SIRS.",
keywords = "C-reactive protein, Cytokines, Diabetic ketoacidosis, Systemic inflammatory response syndrome",
author = "Dalton, {Rory R.} and Hoffman, {William H.} and Passmore, {Gregory G} and Martin, {S. Lee Anne}",
year = "2003",
month = "9",
day = "1",
language = "English (US)",
volume = "33",
pages = "435--442",
journal = "Annals of Clinical and Laboratory Science",
issn = "0091-7370",
publisher = "Association of Clinical Scientists",
number = "4",

}

TY - JOUR

T1 - Plasma C-Reactive Protein Levels in Severe Diabetic Ketoacidosis

AU - Dalton, Rory R.

AU - Hoffman, William H.

AU - Passmore, Gregory G

AU - Martin, S. Lee Anne

PY - 2003/9/1

Y1 - 2003/9/1

N2 - Elevated plasma levels of C-reactive protein (CRP) and IL-6 have been reported to be sensitive indicators of infection in adults with diabetic ketoacidosis (DKA). However, both CRP and the proinflammatory cytokines, which regulate CRP, can be elevated without infection. Our hypothesis was that CRP is increased in young patients with severe DKA, even in the absence of an infection, and may serve as a marker for systemic inflammatory response syndrome (SIRS). In 7 patients with severe DKA without infection, we measured plasma CRP, IL-6, IL-1β and TNF-α levels prior to, during, and following correction of DKA. CRP was significantly but transiently elevated in 4 of the patients prior to or during treatment of DKA, compared to their baseline values (96 hr after correction of DKA). There were significant positive relationships between CRP and both IL-6 and IL-1β prior to treatment (p <0.05); between CRP and IL-6, IL-1β, and TNF-α at 6 hr (p <0.05); and between CRP and IL-1β at 24 hr (p <0.05). The results support the hypothesis that CRP is increased in some patients by severe DKA and its treatment, and that DKA can be associated with a non-infectious form of SIRS.

AB - Elevated plasma levels of C-reactive protein (CRP) and IL-6 have been reported to be sensitive indicators of infection in adults with diabetic ketoacidosis (DKA). However, both CRP and the proinflammatory cytokines, which regulate CRP, can be elevated without infection. Our hypothesis was that CRP is increased in young patients with severe DKA, even in the absence of an infection, and may serve as a marker for systemic inflammatory response syndrome (SIRS). In 7 patients with severe DKA without infection, we measured plasma CRP, IL-6, IL-1β and TNF-α levels prior to, during, and following correction of DKA. CRP was significantly but transiently elevated in 4 of the patients prior to or during treatment of DKA, compared to their baseline values (96 hr after correction of DKA). There were significant positive relationships between CRP and both IL-6 and IL-1β prior to treatment (p <0.05); between CRP and IL-6, IL-1β, and TNF-α at 6 hr (p <0.05); and between CRP and IL-1β at 24 hr (p <0.05). The results support the hypothesis that CRP is increased in some patients by severe DKA and its treatment, and that DKA can be associated with a non-infectious form of SIRS.

KW - C-reactive protein

KW - Cytokines

KW - Diabetic ketoacidosis

KW - Systemic inflammatory response syndrome

UR - http://www.scopus.com/inward/record.url?scp=0142089072&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0142089072&partnerID=8YFLogxK

M3 - Article

C2 - 14584758

AN - SCOPUS:0142089072

VL - 33

SP - 435

EP - 442

JO - Annals of Clinical and Laboratory Science

JF - Annals of Clinical and Laboratory Science

SN - 0091-7370

IS - 4

ER -