Serum C-reactive protein levels correlates better to metabolic syndrome defined by International Diabetes Federation than by NCEP ATP III in men.

The International Diabetes Federation (IDF) proposed a new definition for metabolic syndrome (MS) in 2005. We conducted this study to compare the association of MS by IDF and ATP III definition to various metabolic variables. In 2005, we enrolled 654 Chinese people in a screening program in Taiwan. Anthropometric and biochemical profiles, including high-sensitivity C-reactive protein (hsCRP), were measured. Serum hsCRP levels were higher in those with MS by IDF definition (2.4+/-1.9mg/l versus 1.3+/-1.4mg/l, p<0.0001). Serum hsCRP levels increase with the number of components of MS they met (p for trend<0.001). Serum LDL levels were higher in those with MS by IDF definition (131+/-39 versus 125+/-32, p<0.05) but not in those with MS by ATP III definition (p=0.2). Serum hsCRP levels correlate significantly to MS by ATP III definition, after adjusting for age, sex, smoking, body mass index, serum apolipoprotein A1 and LDL levels. Adding MS status by IDF definition in this model significantly increased model fitness in men (MS by IDF definition, partial r=0.18, p<0.05, MS by ATP III definition, partial r=0.12, p=0.071). In conclusion, IDF definition of MS has a stronger relationship with serum hsCRP than ATP III definition in men.

[1]  M. Cassader,et al.  The metabolic syndrome and high C‐reactive protein: prevalence and differences by sex in a southern‐European population‐based cohort , 2005, Diabetes/metabolism research and reviews.

[2]  S. Kiechl,et al.  Prevalence of insulin resistance in metabolic disorders: the Bruneck Study. , 1998, Diabetes.

[3]  J. Tuomilehto,et al.  Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? , 2003, Diabetes care.

[4]  R. Blumenthal,et al.  The relationship between blood pressure and C-reactive protein in the Multi-Ethnic Study of Atherosclerosis (MESA). , 2005, Journal of the American College of Cardiology.

[5]  H. Baumann,et al.  Insulin is a prominent modulator of the cytokine-stimulated expression of acute-phase plasma protein genes. , 1992, Molecular and cellular biology.

[6]  S. Haffner,et al.  Geographic variations of the International Diabetes Federation and the National Cholesterol Education Program-Adult Treatment Panel III definitions of the metabolic syndrome in nondiabetic subjects. , 2006, Diabetes care.

[7]  J. Manson,et al.  C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. , 2001, JAMA.

[8]  Paul Zimmet,et al.  [A new international diabetes federation worldwide definition of the metabolic syndrome: the rationale and the results]. , 2005, Revista espanola de cardiologia.

[9]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[10]  M. Clearfield C-Reactive Protein: A New Risk Assessment Tool for Cardiovascular Disease , 2005, The Journal of the American Osteopathic Association.

[11]  J. Geleijnse,et al.  Relationship of C-reactive protein with components of the metabolic syndrome in normal-weight and overweight elderly. , 2005, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[12]  S. Coppack,et al.  Endothelial Dysfunction: Cause of the Insulin Resistance Syndrome , 1997, Diabetes.

[13]  Tom R. Gaunt,et al.  C-reactive protein and its role in metabolic syndrome: mendelian randomisation study , 2005, The Lancet.

[14]  E. Ford,et al.  Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. , 2004, Archives of internal medicine.

[15]  P. Ridker Clinical application of C-reactive protein for cardiovascular disease detection and prevention. , 2003, Circulation.

[16]  T Nakamura,et al.  Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men. , 1994, Atherosclerosis.

[17]  K. Feingold,et al.  Role of Cytokines in Inducing Hyperlipidemia , 1992, Diabetes.

[18]  James T. Willerson,et al.  Direct Proinflammatory Effect of C-Reactive Protein on Human Endothelial Cells , 2000, Circulation.

[19]  J. Pickup Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. , 2004, Diabetes care.

[20]  C. Lopes,et al.  Central obesity as a major determinant of increased high-sensitivity C-reactive protein in metabolic syndrome , 2005, International Journal of Obesity.

[21]  M. Clark,et al.  Acute impairment of insulin-mediated capillary recruitment and glucose uptake in rat skeletal muscle in vivo by TNF-alpha. , 2000, Diabetes.

[22]  R. Nesto,et al.  The relation of insulin resistance syndromes to risk of cardiovascular disease. , 2003, Reviews in cardiovascular medicine.

[23]  L. Kuller,et al.  C-reactive protein, heart disease risk, and the popular media. , 2005, Archives of internal medicine.

[24]  C-C Lin,et al.  Insulin resistance, obesity, and metabolic syndrome among non-diabetic pre- and post-menopausal women in North Taiwan , 2006, International Journal of Obesity.

[25]  P. Zimmet,et al.  Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[26]  I. Kushner Regulation of the Acute Phase Response by Cytokines , 2015, Perspectives in biology and medicine.

[27]  P. Ridker,et al.  High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. , 2001, Circulation.

[28]  M. Rutter,et al.  C-Reactive Protein, the Metabolic Syndrome, and Prediction of Cardiovascular Events in the Framingham Offspring Study , 2004, Circulation.

[29]  J. Shaw,et al.  Impaired fasting glucose: how low should it go? , 2000, Diabetes care.

[30]  Jane B Shofer,et al.  Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. , 2004, Diabetes.

[31]  B. Tomlinson,et al.  Factor analysis of the metabolic syndrome: obesity vs insulin resistance as the central abnormality , 2001, International Journal of Obesity.

[32]  S. Weisnagel,et al.  Relation of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and fibrinogen to abdominal adipose tissue, blood pressure, and cholesterol and triglyceride levels in healthy postmenopausal women. , 2005, The American journal of cardiology.