© 2010 Dalan et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2010:3 187–195 Diabetes, Metabolic Syndrome and Obesity: Targets and herapy Dovepress submit your manuscript | www.dovepress.com Dovepress 187 OriginAL reSeArch open access to scientific and medical research Open Access Full Text Article 10721 high-sensitivity c-reactive protein concentrations among patients with and without diabetes in a multiethnic population of Singapore: creDence Study rinkoo Dalan 1 Michelle Jong 1 Siew-Pang chan 4,5 robert hawkins 2 robin choo 6 Brenda Lim 1 May L Tan 3 Melvin KS Leow 1,6 1 Department of endocrinology, 2 Department of Laboratory Medicine, 3 healt h enrichment centre, Tan Tock Seng hospital, Singapore; 4 School of Business, SiM University, Singapore; 5 Faculty of healt h Sciences, La Trobe University, Australia; 6 Singapore inst itute for clini cal Sciences, Brenner centre for Molecular Medicine, Singapore correspondence: r Dalan Department of endocrinology, Tan Tock Seng hospital, 11 Jalan Tan Tock Seng, Singapore 308433 email rinkoo_dalan@ttsh.com.sg Objectives: To determine whether high-sensitivity C-reactive protein (hs-CRP) concentrations differ between Chinese, Malays, and Indians with and without type 2 diabetes mellitus and to look for an association with demographic, metabolic and therapeutic variables. Methods: Phase 1: We retrieved records of 50 Chinese, 51 Malay, and 67 Indian individuals who had routine health screening blood tests. Phase 2: We recruited 111 Chinese, 68 Malays, and 67 Indians with type 2 diabetes mellitus and measured their hs-CRP in addition to standard laboratory tests. Results: Phase 1: The median hs-CRP was 0.6 mg/L (0.2–6.2) in Chinese, 1.2 mg/L (0.2–7.9) in Malays, and 1.9 mg/L (0.2–10.0) in Indians. The Indians had higher hs-CRP compared to Chinese (P , 0.05) when adjusted for age, sex, body mass index (BMI), lipids, blood pressure, and smoking, and a significant correlation was seen between female sex, smoking status, fast- ing glucose and triglyceride concentration, and hs-CRP in all three ethnicities. Phase 2: The median hs-CRP was 1.2 mg/L (0.2–9.9) in Chinese, 2.2 mg/L (0.2–9.0) in Malays, and 2.3 mg/L (0.2–9.8) in Indians. Indians had higher hs-CRP when compared to Chinese (P , 0.05) and a significant correlation was seen between BMI, female gender, diabetes, and the use of metformin and hs-CRP in all three ethnicities (P , 0.05) when adjusted for the above variables and use of aspirin, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACE-I/ARB), statin, metformin, rosiglitazone, sulfonylurea, glinides, acarbose, and insulin. Conclusion: hs-CRP concentrations are significantly higher in Indians compared to the Chinese (in both the diabetic and nondiabetic individuals) after adjustment for the various demographic, metabolic, and therapeutic variables. Keywords: C-reactive protein, ethnicity, diabetes mellitus, cardiovascular disease Introduction Singapore is a small and densely populated country of 4.59 million people. There are three major ethnic groups: 75% Chinese, 13.7% Malays, 8.7% Indians (South Asians who trace their ancestry from the Indian subcontinent), and 2.6% others (http://www. singstat.gov.sg). In Singapore, it has been seen that Indians are at increased risk of developing coronary heart disease (CHD) when compared to other populations. 1 On average, Indians are at three-fold risk and Malays two-fold risk when compared to Chinese. Previous cross-sectional studies have shown that the greater susceptibility of Indians to CHD is not explained by higher incidence of the traditional risk factors