C-reactive protein concentration and severity of coronary atherosclerosis in type II diabetic patients. Acute inflammation induced by elevated levels of serum C-reactive protein (CRP) has been implicated in the pathogenesis of atherosclerosis. Because diabetes is known to be associated with systemic inflammation, we examined the relationship between the extent of coronary atherosclerosis and CRP levels in patients with type II diabetes. We measured the extent of coronary atherosclerosis using quantitative coronary angiography and determined CRP levels in 117 patients with type II diabetes and in 65 control subjects. CRP levels were significantly higher in the patients than in the control subjects (0.93 +/- 0.43 vs 0.54 +/- 0.32 mg/L; P < .001). The extent of coronary atherosclerosis was significantly greater in patients with CRP levels greater than or equal to 2 mg/L (greater than or equal to 2.24 mg/L, P = .006) than in those with CRP levels less than 2 mg/L. Furthermore, CRP levels showed a significant positive correlation with the extent of coronary atherosclerosis (r = 0.21, P = .04) in the diabetic patients. However, no significant correlation was observed between CRP levels and the severity of coronary atherosclerosis in the control subjects (r = 0.19, P = .19). These results suggest that elevated CRP levels were associated with increased coronary atherosclerosis in patients with type II diabetes. CRP levels may play a significant role in the development of coronary atherosclerosis in diabetic patients.