American Journal of Medicine and Medical Sciences

p-ISSN: 2165-901X    e-ISSN: 2165-9036

2025;  15(6): 1917-1920

doi:10.5923/j.ajmms.20251506.61

Received: May 20, 2025; Accepted: Jun. 17, 2025; Published: Jun. 20, 2025

 

The Association of CRP and Vitamin D Deficiency with Cardiovascular Disease: A Study among Prediabetic Patients in Andijan City and Markhamat District of the Republic of Uzbekistan

R. H. Abdurakhmonova

Free Applicant of the Department of Hospital Therapy and Endocrinology, Andijan State Medical Institute, Andijan, Uzbekistan

Correspondence to: R. H. Abdurakhmonova, Free Applicant of the Department of Hospital Therapy and Endocrinology, Andijan State Medical Institute, Andijan, Uzbekistan.

Copyright © 2025 The Author(s). Published by Scientific & Academic Publishing.

This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/

Abstract

The study aimed to assess the association between C-reactive protein (CRP), vitamin D deficiency, and cardiovascular diseases in patients with prediabetes in Andijan city and Markhamat district, Uzbekistan. A total of 3,400 individuals at risk were examined using the Findrisk questionnaire and laboratory tests. Results showed significantly elevated levels of CRP, uric acid, and plasma renin in prediabetic patients compared to the control group (p<0.005; p<0.0001). An inverse correlation was found between vitamin D levels and CRP, renin, and uric acid, indicating their potential role in cardiovascular risk among prediabetic individuals.

Keywords: Vitamin D, C-reactive protein, Prediabetes

Cite this paper: R. H. Abdurakhmonova, The Association of CRP and Vitamin D Deficiency with Cardiovascular Disease: A Study among Prediabetic Patients in Andijan City and Markhamat District of the Republic of Uzbekistan, American Journal of Medicine and Medical Sciences, Vol. 15 No. 6, 2025, pp. 1917-1920. doi: 10.5923/j.ajmms.20251506.61.

1. Introduction

Cardiovascular disease (CVD) is commonly perceived as a major public health problem leading to high morbidity and mortality rates. Extensive and mounting evidence suggests that inflammation is an important part of this chronic condition [1]. Vitamin D is a fat-soluble steroid that has been found to play an important role in the regulation of inflammatory cytokines and immune cells [2]. Novel studies have shown that vitamin D deficiency is associated with increased inflammatory responses and immune system activation, and may have an inverse relationship with various pathological processes such as myocardial infarction [3,4,5].
C-reactive protein (CRP), which is a sensitive indicator of inflammation, has been demonstrated as an important element in predicting cardiovascular disease in a number of prospective epidemiological studies. One such study suggested that the inclusion of SRB measurement in screening based on lipid levels could significantly improve the methodology for identifying women at risk of cardiovascular events [6,7,8].
Observational studies have demonstrated an association between reduced serum vitamin D levels and an increased risk of cardiovascular disease. At the same time, optimal vitamin D levels seem to have a positive effect on the cardiovascular system, which may be partly explained by its immunomodulatory and anti-inflammatory properties [9,10,11].
Randomised controlled trials (RCTs) and information on the relationship between vitamin D intake through food or supplements and cardiovascular disease risk show mixed results: some studies indicate a beneficial effect, while others find no association with cardiovascular disease. There is a possibility that the effect of vitamin D supplementation may vary depending on C-reactive protein (CRP) levels [12].
All of the above provided the basis for the present study.
The aim of the study was to investigate the association of C-reactive protein and vitamin D deficiency with cardiovascular diseases: a study among patients with prediabetes in Andijan city and Markhamat district of the Republic of Uzbekistan.

2. Material and Methods of Research

The study was conducted on the basis of Andijan State Medical Institute. In total 3400 persons of risk groups were examined, of which 1800 were residents of Markhamat district of Andijan region and 1600 residents of Andijan city. The control group consisted of 30 healthy people.
Inclusion criteria: individuals over 20 years of age who were overweight, dyslipidaemic or hypertensive.
Exclusion criteria: type 1 diabetes mellitus, other endocrine diseases, metformin use, severe autoimmune diseases, vasculitis, oncology.
According to the design, the study was conducted in two phases.
At stage 1, according to the study design, cardiovascular risk factors including waist circumference, body mass index (BMI), blood pressure level, lipid profile, presence of diabetes mellitus and metabolic syndrome, and anamnestic information extracted from relevant medical records were analysed. Patients were questionnaired using the Findrisk scale.
At the 2nd stage, freshly collected biological material (venous blood) was collected and then promptly delivered to the laboratory for research.
The study methods included general clinical approaches, biochemical testing (measurement of fasting blood glucose levels and two hours after meals, determination of glycated haemoglobin, bilirubin (both direct and indirect), as well as ALT, AST, PTI, coagulogram, C-reactive protein, urea, creatinine and lipid profile), hormonal analyses (insulin and C-peptide levels in the blood as needed) and instrumental methods such as ECG, ultrasound of endocrine glands and internal organs, chest X-ray and other tests.
Data were expressed as mean ± SD, n (%) or OR (95% CI), all statistical tests were two-sided, and a P value < 0.05 was considered statistically significant.
Multiple logistic regression was used to determine the independent association between 25(OH)D status, with normal 25(OH)D as the reference category, and high and low CRP and CVD levels, respectively, after adjusting for demographic variables including age, sex, physical activity, education level, marital status, family history, chronic kidney disease, alcohol consumption, BMI, hypertension, diabetes mellitus, and hypercholesterolemia.
We selected covariates as potential confounders based on previous studies or on their biological plausibility. The following covariates were included in our association analysis: age, sex, body mass index (BMI), marital status, education level, smoking status, alcohol consumption, physical activity, hypertension, diabetes, hypercholesterolaemia, chronic kidney disease (CKD), BMI, and dyslipidaemia.

3. Results of the Study

Figure 1 shows the material and design of the study.
Figure 1. Material and study design
The next step of our research was to assess the content of vitamin D and C-reactive protein in the study groups by region. These data are shown in Table 1.
Table 1. Mean value of laboratory vitamin D and C-reactive protein in the study groups by region
     
The data in Table 1 show that the mean values of CRP were significantly higher than the control group in all groups and regions (p<0.005; p<0.0001). At the same time, mean values of uric acid vitamin were significantly higher in patients in all groups (p<0.005). Also, mean plasma renin values were significantly elevated in all patient groups (p<0.005; p<0.0001).
Further we studied the prevalence of vitamin D3 deficiency in prediabetics in comparative aspect in Markhamat district and Andijan city (Table 2 and 3).
Table 2 shows that a total of 132 (71.7%) patients with various degrees of vitamin D deficiency were identified among 184 patients in Markhamat district. That is, the predominant majority had vitamin D deficiency, with 24 (13%) having severe deficiency, 66 (35.8%) having moderate deficiency, 27 (14.7%) having moderate deficiency and 15 (8.2%) having mild deficiency.
Table 2. Prevalence of vitamin D3 deficiency in prediabetics in Markhamat district
     
Table 3 shows that a total of 129 (71.6%) patients with different degrees of vitamin D deficiency were identified among 180 patients in Andijan city. That is, the predominant majority had vitamin D deficiency, with 9 (5.0%) having severe deficiency, 92 (51.1%) having moderate deficiency, 25 (13.9%) having moderate deficiency and 3 (1.6%) having mild deficiency.
Table 3. Prevalence of vitamin D3 deficiency in prediabetics in Andijan
     
Thus, we see that vitamin D deficiency of severe degree dominated in Markhamat district - 24 cases: 9 cases in Andijan city.
The last step was the correlation analysis between vitamin D deficiency as a leading risk factor for CVD with renin, CRP and other parameters (Table 4).
Table 4. Correlation between vitamin D deficiency as a leading CVD risk factor with renin, CRP and uric acid in prediabetic patients in Markhamat district and Andijan city
     
Table 4 shows that there was a significant inverse correlation between vitamin D, CRP, renin and uric acid content in almost all groups of prediabetic patients from both regions (p<0.005).
Thus, in this study we analysed the hypothesis of the relationship between 25(OH)D and CRP levels and cardiovascular diseases based on a representative sample of adult residents of Andijan region and Andijan city of the Republic of Uzbekistan.

4. Conclusions

1. According to our studies, the mean values of SRB were significantly higher than the control group in all groups and regions (*-P<0.005; **-P<0.0001).
2. A significant inverse correlation between vitamin D, SRB, renin and uric acid content was found in almost all groups of prediabetes patients of both regions (P<0.005).

References

[1]  Qiu M, Shen W, Song X, Ju L, Tong W, Wang H, Zheng S, Jin Y, Wu Y, Wang W, Tian J. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus: a longitudinal study. // Hypertension. 2015 Mar; 65(3): 525-30. doi: 10.1161/HYPERTENSIONAHA.114.04632
[2]  Guillot X, Semerano L, Saidenberg-Kermanac'h N, Falgarone G, Boissier MC. Vitamin D and inflammation. // Joint Bone Spine. 2010 Dec; 77(6): 552-7. doi: 10.1016/j.jbspin.2010.09.018.
[3]  Colotta F, Jansson B, Bonelli F. Modulation of inflammatory and immune responses by vitamin D. // J Autoimmun. 2017 Dec; 85: 78-97. doi: 10.1016/j.jaut.2017.07.007.
[4]  Jiménez-Sousa, María Ángeles, et al. "Vitamin D in human immunodeficiency virus infection: influence on immunity and disease." // Frontiers in immunology 9 (2018): 458.
[5]  Ridker, Paul M. "Clinical application of C-reactive protein for cardiovascular disease detection and prevention." // Circulation 107.3 (2003): 363-369.
[6]  Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. // N Engl J Med. 2000 Mar 23; 342(12): 836-43. doi: 10.1056/NEJM200003233421202.
[7]  Lopez-Garcia E, Schulze MB, Fung TT, Meigs JB, Rifai N, Manson JE, Hu FB. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. // Am J Clin Nutr. 2004 Oct; 80(4): 1029-35. doi: 10.1093/ajcn/80.4.1029.
[8]  Wannamethee SG, Lowe GD, Whincup PH, Rumley A, Walker M, Lennon L. Physical activity and hemostatic and inflammatory variables in elderly men. // Circulation. 2002 Apr 16; 105(15): 1785-90. doi: 10.1161/hc1502.107117.
[9]  Demer LL, Hsu JJ, Tintut Y. Steroid Hormone Vitamin D: Implications for Cardiovascular Disease. // Circ Res. 2018 May 25; 122(11): 1576-1585. doi: 10.1161/CIRCRESAHA.118.311585.
[10]  Zittermann A, Schleithoff SS, Koerfer R. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr. 2005 Oct; 94(4): 483-92. doi: 10.1079/bjn20051544.
[11]  Holick, Michael F. "Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease." // The American journal of clinical nutrition 80.6 (2004): 1678S-1688S.
[12]  Inanir A, Ozoran K, Tutkak H, Mermerci B. The effects of calcitriol therapy on serum interleukin-1, interleukin-6 and tumour necrosis factor-alpha concentrations in post-menopausal patients with osteoporosis. // J Int Med Res. 2004 Nov-Dec; 32(6): 570-82. doi: 10.1177/147323000403200602.
[13]  Mukhamedova V. M., Nishanova M. S. Obesity is a Risk Factor for Prediabetes. American Journal of Medicine and Medical Sciences p-ISSN: 2165-901X e-ISSN: 2165-9036 2024; 14(4): 1077-1079 doi:10.5923/j.ajmms.20241404.57.
[14]  Yusupova S, Nishanova M. ASSESSMENT OF PREDIABETES PREVALENCE AMONG RURAL AND URBAN POPULATIONS OF ANDIJAN. MSU [Internet]. 2025 Apr. 16 [cited 2025 May 17]; (2): 169-76. Available from: https://fdoctors.uz/index.php/journal/article/view/157.
[15]  Yusupova Sh, Mukhamedova V, Matkarimova M. Evaluation of the frequency of occurrence of risk factors for disorders of carbohydrate metabolism. MSU [Internet]. 16 Apr 2025; (2): 18-20. available at: https://fdoctors.uz/index.php/journal/article/view/107. doi: https://doi.org/10.56121/2181-3612-2025-2-18-20.