(Circulation. 2000;102:42.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio (A.F., L.M., S.M.H.); Department of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC (R.DA., G.H.); and Laboratory for Clinical Biochemistry Research, Department of Pathology, University of Vermont College of Medicine, Burlington (R.P.T.).
Correspondence to Andreas Festa, MD, University of Texas Health Science Center at San Antonio, Mail Code 7873, 7703 Floyd Curl Dr, San Antonio, TX 78228-3900. E-mail festa{at}magnet.at
BackgroundInflammation has been suggested as a risk factor for the development of atherosclerosis. Recently, some components of the insulin resistance syndrome (IRS) have been related to inflammatory markers. We hypothesized that insulin insensitivity, as directly measured, may be associated with inflammation in nondiabetic subjects.
Methods and ResultsWe studied the relation of C-reactive protein (CRP), fibrinogen, and white cell count to components of IRS in the nondiabetic population of the Insulin Resistance Atherosclerosis Study (IRAS) (n=1008; age, 40 to 69 years; 33% with impaired glucose tolerance), a multicenter, population-based study. None of the subjects had clinical coronary artery disease. Insulin sensitivity (SI) was measured by a frequently sampled intravenous glucose tolerance test, and CRP was measured by a highly sensitive competitive immunoassay. All 3 inflammatory markers were correlated with several components of the IRS. Strong associations were found between CRP and measures of body fat (body mass index, waist circumference), SI, and fasting insulin and proinsulin (all correlation coefficients >0.3, P<0.0001). The associations were consistent among the 3 ethnic groups of the IRAS. There was a linear increase in CRP levels with an increase in the number of metabolic disorders. Body mass index, systolic blood pressure, and SI were related to CRP levels in a multivariate linear regression model.
ConclusionsWe suggest that chronic subclinical inflammation is part of IRS. CRP, a predictor of cardiovascular events in previous reports, was independently related to SI. These findings suggest potential benefits of anti-inflammatory or insulin-sensitizing treatment strategies in healthy individuals with features of IRS.
Key Words: inflammation proteins insulin resistance syndrome insulin atherosclerosis
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Z. Su, Y. Li, J. C. James, A. H. Matsumoto, G. A. Helm, A. J. Lusis, and W. Shi Genetic linkage of hyperglycemia, body weight and serum amyloid-P in an intercross between C57BL/6 and C3H apolipoprotein E-deficient mice Hum. Mol. Genet., May 15, 2006; 15(10): 1650 - 1658. [Abstract] [Full Text] [PDF] |
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A. Guven, A. Cetinkaya, M. Aral, G. Sokmen, M. A. Buyukbese, A. Guven, and N. Koksal High-Sensitivity C-Reactive Protein in Patients with Metabolic Syndrome Angiology, May 1, 2006; 57(3): 295 - 302. [Abstract] [PDF] |
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K. Esposito, M. Ciotola, D. Carleo, B. Schisano, F. Saccomanno, F. C. Sasso, D. Cozzolino, R. Assaloni, D. Merante, A. Ceriello, et al. Effect of Rosiglitazone on Endothelial Function and Inflammatory Markers in Patients With the Metabolic Syndrome Diabetes Care, May 1, 2006; 29(5): 1071 - 1076. [Abstract] [Full Text] [PDF] |
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J. M. Starkey, S. J. Haidacher, W. S. LeJeune, X. Zhang, B. C. Tieu, S. Choudhary, A. R. Brasier, L. A. Denner, and R. G. Tilton Diabetes-Induced Activation of Canonical and Noncanonical Nuclear Factor-{kappa}B Pathways in Renal Cortex. Diabetes, May 1, 2006; 55(5): 1252 - 1259. [Abstract] [Full Text] [PDF] |
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J. A. Bell, E. Volpi, S. Fujita, J. G. Cadenas, M. Sheffield-Moore, and B. B. Rasmussen Skeletal Muscle Protein Anabolic Response to Increased Energy and Insulin Is Preserved in Poorly Controlled Type 2 Diabetes J. Nutr., May 1, 2006; 136(5): 1249 - 1255. [Abstract] [Full Text] [PDF] |
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S. M. Haffner Abdominal obesity, insulin resistance, and cardiovascular risk in pre-diabetes and type 2 diabetes Eur. Heart J. Suppl., May 1, 2006; 8(suppl_B): B20 - B25. [Abstract] [Full Text] [PDF] |
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L. E. Bernstein, J. Berry, S. Kim, B. Canavan, and S. K. Grinspoon Effects of Etanercept in Patients With the Metabolic Syndrome. Arch Intern Med, April 24, 2006; 166(8): 902 - 908. [Abstract] [Full Text] [PDF] |
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A. Festa, K. Williams, R. P. Tracy, L. E. Wagenknecht, and S. M. Haffner Progression of Plasminogen Activator Inhibitor-1 and Fibrinogen Levels in Relation to Incident Type 2 Diabetes Circulation, April 11, 2006; 113(14): 1753 - 1759. [Abstract] [Full Text] [PDF] |
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A. Oberbach, A. Tonjes, N. Kloting, M. Fasshauer, J. Kratzsch, M. W Busse, R. Paschke, M. Stumvoll, and M. Bluher Effect of a 4 week physical training program on plasma concentrations of inflammatory markers in patients with abnormal glucose tolerance. Eur. J. Endocrinol., April 1, 2006; 154(4): 577 - 585. [Abstract] [Full Text] [PDF] |
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L. Moretti and T. Canada A Randomized Study Comparing the Effects of a Low-Carbohydrate Diet and a Conventional Diet on Lipoprotein Subfractions and C-reactive Protein Levels in Patients With Severe Obesity Nutr Clin Pract, April 1, 2006; 21(2): 187 - 188. [Abstract] [Full Text] [PDF] |
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R. P Raghavan, D. W Laight, K. M Shaw, and M. H Cummings Review: Aspirin and diabetes The British Journal of Diabetes & Vascular Disease, March 1, 2006; 6(2): 74 - 82. [Abstract] [PDF] |
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M. Mohlig, M. Freudenberg, T. Bobbert, M. Ristow, H. Rochlitz, M. O. Weickert, A. F. H. Pfeiffer, and J. Spranger Acetylsalicylic Acid Improves Lipid-Induced Insulin Resistance in Healthy Men J. Clin. Endocrinol. Metab., March 1, 2006; 91(3): 964 - 967. [Abstract] [Full Text] [PDF] |
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K. Lobner, A. Knopff, A. Baumgarten, U. Mollenhauer, S. Marienfeld, M. Garrido-Franco, E. Bonifacio, and A.-G. Ziegler Predictors of Postpartum Diabetes in Women With Gestational Diabetes Mellitus Diabetes, March 1, 2006; 55(3): 792 - 797. [Abstract] [Full Text] [PDF] |
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M. Soinio, J. Marniemi, M. Laakso, S. Lehto, and T. Ronnemaa High-Sensitivity C-Reactive Protein and Coronary Heart Disease Mortality in Patients With Type 2 Diabetes: A 7-year follow-up study Diabetes Care, February 1, 2006; 29(2): 329 - 333. [Abstract] [Full Text] [PDF] |
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C. Gubern, A. Lopez-Bermejo, J. Biarnes, J. Vendrell, W. Ricart, and J. M. Fernandez-Real Natural Antibiotics and Insulin Sensitivity: The Role of Bactericidal/Permeability-Increasing Protein Diabetes, January 1, 2006; 55(1): 216 - 224. [Abstract] [Full Text] [PDF] |
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J. F. Navarro and C. Mora Role of inflammation in diabetic complications Nephrol. Dial. Transplant., December 1, 2005; 20(12): 2601 - 2604. [Full Text] [PDF] |
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A. Tsuchida, T. Yamauchi, S. Takekawa, Y. Hada, Y. Ito, T. Maki, and T. Kadowaki Peroxisome Proliferator-Activated Receptor (PPAR){alpha} Activation Increases Adiponectin Receptors and Reduces Obesity-Related Inflammation in Adipose Tissue: Comparison of Activation of PPAR{alpha}, PPAR{gamma}, and Their Combination Diabetes, December 1, 2005; 54(12): 3358 - 3370. [Abstract] [Full Text] [PDF] |
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H. Koyama, T. Shoji, H. Yokoyama, K. Motoyama, K. Mori, S. Fukumoto, M. Emoto, T. Shoji, H. Tamei, H. Matsuki, et al. Plasma Level of Endogenous Secretory RAGE Is Associated With Components of the Metabolic Syndrome and Atherosclerosis Arterioscler Thromb Vasc Biol, December 1, 2005; 25(12): 2587 - 2593. [Abstract] [Full Text] [PDF] |
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A. J.G. Hanley, K. Williams, A. Festa, L. E. Wagenknecht, R. B. D'Agostino Jr, and S. M. Haffner Liver Markers and Development of the Metabolic Syndrome: The Insulin Resistance Atherosclerosis Study Diabetes, November 1, 2005; 54(11): 3140 - 3147. [Abstract] [Full Text] [PDF] |
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L. Kalra, C. Rambaran, P. Chowienczyk, D. Goss, I. Hambleton, J. Ritter, A. Shah, R. Wilks, and T. Forrester Ethnic Differences in Arterial Responses and Inflammatory Markers in Afro-Caribbean and Caucasian Subjects Arterioscler Thromb Vasc Biol, November 1, 2005; 25(11): 2362 - 2367. [Abstract] [Full Text] [PDF] |
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A. M Carter Inflammation, thrombosis and acute coronary syndromes Diabetes and Vascular Disease Research, October 1, 2005; 2(3): 113 - 121. [Abstract] [PDF] |
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T. A. Lakka, H.-M. Lakka, T. Rankinen, A. S. Leon, D.C. Rao, J. S. Skinner, J. H. Wilmore, and C. Bouchard Effect of exercise training on plasma levels of C-reactive protein in healthy adults: the HERITAGE Family Study Eur. Heart J., October 1, 2005; 26(19): 2018 - 2025. [Abstract] [Full Text] [PDF] |
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the Diabetes Prevention Program Research Group Lipid, Lipoproteins, C-Reactive Protein, and Hemostatic Factors at Baseline in the Diabetes Prevention Program Diabetes Care, October 1, 2005; 28(10): 2472 - 2479. [Abstract] [Full Text] [PDF] |
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