High-sensitivity C-reactive Protein and Cardiovascular Disease Risk Assessment in a Population of Type 2 Diabetes Mellitus Patients

Background: 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 specialist care. Methods: 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 using a homogenous immunoassay on the Cobas c311® automated random-access analyzer, while 10-year CVD risk was estimated with the WHO CVD risk assessment chart for Western sub-Saharan Africa. Statistical analyses, including multinomial logistic regression to assess the association between hsCRP and CVD risk, were conducted using SPSS version 25, with significance set at p < 0.05. Results: Moderate-to-high CVD risk was prevalent in 51.5% of the study population with the Tiv ethnic group having the highest proportion (p = 0.041). Longer diabetes duration (OR = 1.95, 95% CI: 1.10–3.45, p = 0.021) and elevated fasting blood glucose (OR = 2.18, 95% CI: 1.31–3.62, p = 0.003) 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, hsCRP was not an independent predictor of CVD risk after adjusting for confounders (p = 0.084). Conclusion: There is a high burden of increased CVD risk in this population despite ongoing management, with prolonged diabetes duration and poor glycaemic control as key predictors. Although hsCRP levels were elevated in higher-risk individuals, they did not independently predict CVD risk. 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.