Relation of C-reactive protein to insulin resistance and cardiovascular risk factors in youth.

OBJECTIVE Insulin resistance and C-reactive protein (CRP) levels are strongly correlated in adults. This study explored the relationship in youth. RESEARCH DESIGN AND METHODS Associations between CRP levels, cardiovascular risk, and insulin resistance measured by the euglycemic clamp were investigated in 342 healthy Minneapolis youth. RESULTS There was no difference in mean CRP levels among boys (n = 189, CRP 1.10 +/- 0.46 mg/l) and girls (n = 153, CRP 1.16 +/- 0.63 mg/l; P = 0.32). There was also no difference between CRP and Tanner stage. CRP, adjusted for BMI, was significantly greater in black subjects compared with white subjects (P = 0.03). CRP was strongly related to adiposity in both girls and boys. CRP levels were related to fasting insulin levels (r = 0.16, P = 0.003) but this association was not significant after adjustment for BMI (r = 0.07, P = 0.21). Similarly, M, the euglycemic clamp measurement of insulin sensitivity, was significantly related to CRP levels (r = -0.13, P = 0.02) but not when M was normalized to lean body mass (M(lbm)) (r = -0.10, P = 0.09). There was a significant inverse correlation between M(lbm) and CRP quartiles, which disappeared after adjustment for BMI. There was no significant association between CRP levels and lipids, blood pressure, physical activity, or left ventricular mass. CONCLUSIONS In contrast to adult subjects, after adjustment for adiposity, CRP levels in children age 10-16 years were not significantly associated with insulin resistance or with other factors comprising the metabolic syndrome. This is consistent with the concept that insulin resistance may precede the development of CRP elevation in the evolution of the metabolic syndrome.

[1]  E. Ford.  C-Reactive Protein Concentration and Cardiovascular Disease Risk Factors in Children: Findings From the National Health and Nutrition Examination Survey 1999–2000 , 2003, Circulation.

[2]  Sidney C. Smith,et al.  MARKERS OF INFLAMMATION AND CARDIOVASCULAR DISEASE: APPLICATION TO CLINICAL AND PUBLIC HEALTH PRACTICE: A STATEMENT FOR HEALTHCARE PROFESSIONALS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND THE AMERICAN HEART ASSOCIATION , 2003 .

[3]  S. Anand,et al.  C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events. , 2003, Vascular medicine.

[4]  S. Shea,et al.  Physical fitness and C-reactive protein level in children and young adults: the Columbia University BioMarkers Study. , 2003, Pediatrics.

[5]  Edward T H Yeh,et al.  Coming of age of C-reactive protein: using inflammation markers in cardiology. , 2003, Circulation.

[6]  Gary L Myers,et al.  Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. , 2003, Circulation.

[7]  Nancy R Cook,et al.  C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women , 2003, Circulation.

[8]  Jin-Biou Chang,et al.  Plasma C-reactive protein levels and their relationship to anthropometric and lipid characteristics among children. , 2003, Journal of clinical epidemiology.

[9]  C. Basch,et al.  Obesity, fasting plasma insulin, and C-reactive protein levels in healthy children. , 2003, Obesity research.

[10]  N. Sattar,et al.  Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. , 2002, Diabetes care.

[11]  D. Jacobs,et al.  Association of physical activity with insulin sensitivity in children , 2002, International Journal of Obesity.

[12]  M. Litaker,et al.  Hemostatic and inflammatory markers in obese youths: effects of exercise and adiposity. , 2002, The Journal of pediatrics.

[13]  J. Ruidavets,et al.  Prevalence of insulin resistance syndrome in southwestern France and its relationship with inflammatory and hemostatic markers. , 2002, Diabetes care.

[14]  T. Lehtimäki,et al.  Elevated Serum C-Reactive Protein Levels and Early Arterial Changes in Healthy Children , 2002, Arteriosclerosis, thrombosis, and vascular biology.

[15]  D. Jacobs,et al.  Relation of insulin resistance to blood pressure in childhood , 2002, Journal of hypertension.

[16]  D. Jacobs,et al.  Insulin resistance syndrome in childhood: associations of the euglycemic insulin clamp and fasting insulin with fatness and other risk factors. , 2001, The Journal of pediatrics.

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

[18]  D. Galuska,et al.  C-reactive protein and body mass index in children: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. , 2001, The Journal of pediatrics.

[19]  W. Ricart,et al.  Circulating interleukin 6 levels, blood pressure, and insulin sensitivity in apparently healthy men and women. , 2001, The Journal of clinical endocrinology and metabolism.

[20]  M. Kosorok,et al.  Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. , 2001, Pediatrics.

[21]  M. Visser,et al.  Low-grade systemic inflammation in overweight children. , 2001, Pediatrics.

[22]  S. Haffner,et al.  Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). , 2000, Circulation.

[23]  E. Ford,et al.  Serum C-reactive protein and self-reported stroke: findings from the Third National Health and Nutrition Examination Survey. , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[24]  D. Strachan,et al.  C-reactive protein concentration in children: relationship to adiposity and other cardiovascular risk factors. , 2000, Atherosclerosis.

[25]  S. Meri,et al.  Regulation of complement activation by C-reactive protein: targeting the complement inhibitory activity of factor H by an interaction with short consensus repeat domains 7 and 8-11. , 1999, Journal of immunology.

[26]  D. Jacobs,et al.  Insulin resistance during puberty: results from clamp studies in 357 children. , 1999, Diabetes.

[27]  S. Coppack,et al.  C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? , 1999, Arteriosclerosis, thrombosis, and vascular biology.

[28]  Mold,et al.  Complement regulation in innate immunity and the acute‐phase response: inhibition of mannan‐binding lectin‐initiated complement cytolysis by C‐reactive protein (CRP) , 1998, Clinical and experimental immunology.

[29]  R. Tracy,et al.  Variability in the measurement of C-reactive protein in healthy subjects: implications for reference intervals and epidemiological applications. , 1997, Clinical chemistry.

[30]  W. Tamborlane,et al.  Co-existence of severe insulin resistance and hyperinsulinaemia in pre-adolescent obese children , 1996, Diabetologia.

[31]  S. Arslanian,et al.  Insulin sensitivity, lipids, and body composition in childhood: is "syndrome X" present? , 1996, The Journal of clinical endocrinology and metabolism.

[32]  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.

[33]  A. Baron,et al.  Use of a variable tracer infusion method to determine glucose turnover in humans. , 1990, The American journal of physiology.

[34]  R A Boileau,et al.  Skinfold equations for estimation of body fatness in children and youth. , 1988, Human biology.