Relationship of C-reactive protein with components of the metabolic syndrome in normal-weight and overweight elderly

Association between C-Reactive Protein and Metabolic Syndrome in Korean Adults

Background

The prevalence of metabolic syndrome (MetS) is increasing, and obesity, insulin resistance, and inflammation are the known risk factors. However, results of previous studies regarding the relationship between MetS and inflammation have not been consistent. This study aimed to identify the associations between C-reactive protein (CRP) and MetS and its components in obese and non-obese men and women.

Methods

This was a cross-sectional study based on the 6th Korea National Health and Nutrition Examination Survey (2015), and a nationally representative sample of 3,013 Korean adults aged 40–78 years were included. Those with cardiovascular disease, cancer, CRP level >10 mg/L, white blood cell count >10,000/mm³ , chronic kidney disease, and lung/liver disease were excluded.

Results

Approximately 11.0%, 50.0%, 8.4%, and 48.8% of non-obese men, obese men, non-obese women, and obese women presented with MetS (P<0.001), respectively. In all four groups, those who presented with MetS or its components showed a higher high-sensitivity (hs-CRP) average than those without. Multivariate regression analysis showed the increased risk of developing MetS with higher quartiles of hs-CRP level in obese (3rd and 4th quartiles: odds ratios [ORs], 3.87 and 2.57, respectively) and non-obese women (4th quartile: OR, 2.63). The different components also showed increased ORs in the four groups. However, no statistically significant trend in the relationship was found in men.

Conclusion

Low-grade inflammation may increase the risk of MetS in Korean women independent of adiposity. However, due to the cross-sectional design of the present study, further studies must be conducted to identify the causal relationship between inflammation and metabolic disorders.

The importance of HDL-C and CRP in cardiovascular risk evaluation in longevous elderly individuals

The association between total mortality, lipoproteinS, and inflammatory markers, and their implications with aging and longevity are often controversial. Among the most often studied markers are low HDL cholesterol and high C-reactive protein. Particularly in octogenarians, it is expected that the impact of the inclusion of HDL cholesterol and C-reactive protein will improve the stratification of absolute cardiovascular risk. In the present study, we performed a literature review in PubMed about the relation between HDL cholesterol, inflammation and longevity. Applying the inclusion and exclusion criteria adopted, we selected 30 studies, among which one systematic review on the relation between HDL cholesterol and stroke, one meta-analysis on the relation between total cholesterol and HDL cholesterol with mortality, 22 longitudinal studies, and six cross-sectional studies. The results show an inverse association between HDL cholesterol and total mortality, and between cardiovascular mortality and C-reactive protein, as well as a positive association between C-reactive protein and mortality in longevous individuals. C-reactive protein and HDL cholesterol displayed promising characteristics as predictors of cardiovascular mortality in longevous elderly persons.

Obesity and C-reactive protein in various populations: a systematic review and meta-analysis

Obesity has been associated with elevated levels of C-reactive protein (CRP), a marker of inflammation and predictor of cardiovascular risk. The objective of this systematic review and meta-analysis was to estimate the associations between obesity and CRP according to sex, ethnicity and age. MEDLINE and EMBASE databases were searched through October 2011. Data from 51 cross-sectional studies that used body mass index (BMI), waist circumference (WC) or waist-to-hip ratio (WHR) as measure of obesity were independently extracted by two reviewers and aggregated using random-effects models. The Pearson correlation (r) for BMI and ln(CRP) was 0.36 (95% confidence interval [CI], 0.30-0.42) in adults and 0.37 (CI, 0.31-0.43) in children. In adults, r for BMI and ln(CRP) was greater in women than men by 0.24 (CI, 0.09-0.37), and greater in North Americans/Europeans than Asians by 0.15 (CI, 0-0.28), on average. In North American/European children, the sex difference in r for BMI and ln(CRP) was 0.01 (CI, -0.08 to 0.06). Although limited to anthropometric measures, we found similar results when WC and WHR were used in the analyses. Obesity is associated with elevated levels of CRP and the association is stronger in women and North Americans/Europeans. The sex difference only emerges in adulthood.

C-reactive protein and reactive oxygen metabolites in subjects with metabolic syndrome

OBJECTIVE

This cross-sectional study investigated the correlation between diacron reactive oxygen metabolites (d-ROMs) and high-sensitivity C-reactive protein (hs-CRP) in subjects with or without metabolic syndrome.

METHODS

Cardiometabolic risk factors, d-ROMs and hs-CRP were determined in 457 women: 123 with metabolic syndrome and 334 without metabolic syndrome. The correlation between d-ROMs and hs-CRP levels was compared between the two groups.

RESULTS

The group with metabolic syndrome had significantly higher d-ROMs and hs-CRP levels than the group without metabolic syndrome. While the d-ROMs level was significantly and positively correlated with the hs-CRP level in both groups, the correlation level between the two groups was significantly different. Multiple linear regression analysis adjusted for other cardiometabolic risk factors also showed significant positive correlation between dROMs and hs-CRP levels in both groups.

CONCLUSION

Subjects with metabolic syndrome may have a closer relationship between inflammation and oxidative stress than subjects without metabolic syndrome, possibly reflecting their increased predisposition to atherosclerosis. Further studies are necessary to confirm the observed relationship.

Effects of different exercise intensities with isoenergetic expenditures on C-reactive protein and blood lipid levels

We investigated the effects of different exercise intensities on C-reactive protein (CRP), and whether changes in CRP levels correlated with blood lipid levels. Ten men exercised at 25%, 65%, and 85% of their maximum oxygen consumption rates. Participants' blood was analyzed for CRP and blood lipid levels before and after the exercise sessions. Although there was an intensity effect for postexercise high-density lipoprotein levels, there were no significant differences or correlations for postexercise CRP levels or between CRP and lipid levels across the three exercise intensities. In an acute aerobic bout model with isoenergetic expenditures, CRP was not affected by the exercise intensity. Additionally, changes in blood lipid levels might not have been connected to CIRP levels for physically fit participants.

The relationship among central obesity, systemic inflammation, and left ventricular diastolic dysfunction as determined by structural equation modeling

The purpose of this study was to investigate the associations among central obesity, inflammation, and left ventricular (LV) diastolic dysfunction by structural equation modeling. Echocardiographic parameters were assessed in 102 otherwise-healthy adults over age 30. The participants were classified as having LV diastolic dysfunction by echocardiographic findings including mitral inflow E/A ratio <1, deceleration time >220 cm/s, or decreased peak annular early diastolic velocity in tissue Doppler imaging or otherwise the control group. Serum C-reactive protein (CRP) and lipid profile were also measured. The homeostasis model of insulin resistance (HOMA) was calculated. Central obesity was assessed by computerized tomography (CT) at the L4 level. In a multivariate regression analysis, the relationship between visceral adipose tissue (VAT) and LV diastolic dysfunction became insignificant when CRP was introduced into the model, although CRP itself was significantly associated with LV diastolic dysfunction (odds ratio (OR): 1.32, 95% confidence interval (CI): 1.01-1.72, P = 0.04). A significant correlation was also found between VAT and CRP (r = 0.70; P < 0.001). We then performed path analysis as illustrated by the structural equation model. This proved our hypotheses that VAT might affect LV diastolic dysfunction through the effect of CRP (total fat load with inflammation (B = 1.133, P < 0.001) and that inflammation might affect LV diastolic dysfunction (B = 0.373. P < 0.001)). Using structural equation modeling, we concluded that higher amounts of VAT were associated with low-grade inflammation and this may lead to subclinical LV diastolic dysfunction in otherwise-healthy subjects.

Do albuminuria and hs-CRP add to the International Diabetes Federation definition of the metabolic syndrome in predicting outcome?

BACKGROUND

To investigate the added value of elevated urinary albumin excretion (UAE) and high high-sensitive C-reactive protein (hs-CRP) in predicting new-onset type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and chronic kidney disease (CKD) in addition to the present metabolic syndrome (MetS) defining criteria.

METHODS

The PREVEND Study is a prospective population-based cohort study in the Netherlands, including 8592 participants. The MetS was defined according to the 2004 International Diabetes Federation criteria, elevated UAE as albuminuria ≥ 30 mg/24 h and high hs-CRP as ≥ 3 mg/L.

RESULTS

At follow-up, subjects without MetS when compared to subjects with MetS had a lower incidence of T2DM, CVD as well as CKD (2.5 versus 15.5; 4.1 versus 10.3 and 5.8 versus 11.2%, all P < 0.001). In subjects with MetS, the incidence of all three outcomes was higher among subjects with elevated albuminuria versus subjects with normoalbuminuria (all P < 0.01). The incidence of all outcomes was also higher among subjects with high hs-CRP versus subjects without elevated hs-CRP but only significant for CKD (P = 0.002). Multivariate analysis including elevated UAE, hs-CRP and the variables defining the MetS showed that elevated albuminuria was independently associated with the risk for new-onset T2DM, CVD and CKD, whereas high hs-CRP was only independently associated with new-onset CVD and CKD.

CONCLUSION

Our data show that elevated UAE has added value to the present MetS defining variables in predicting new-onset T2DM, CVD and CKD, whereas hs-CRP adds to predicting new-onset CVD and CKD, but not T2DM.

The New Unified International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute Metabolic Syndrome definition: does it correlate better with C-reactive protein in Chinese patients diagnosed with type 2 diabetes?

This study evaluated the association between high-sensitivity C-reactive protein (hsCRP) and metabolic syndrome, defined by the definition proposed by the International Diabetes Federation (IDF), American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI) versus the older IDF definition, in 506 Chinese patients with type 2 diabetes. Anthropometric and biochemical parameters were compared and analysed using multivariate linear regression models. Serum hsCRP was higher in patients with metabolic syndrome compared with those without metabolic syndrome for both definitions and increased as the number of components of metabolic syndrome increased (after adjusting for age, gender and smoking). Patients with metabolic syndrome according to the IDF/AHA/NHLBI but not the IDF definition had significantly higher hsCRP levels than those not meeting either definition and similar hsCRP levels to those meeting both definitions. Serum hsCRP levels were significantly associated with metabolic syndrome according to the IDF definition after adjusting for age, gender and smoking. Adding metabolic syndrome status according to the IDF/AHA/NHLBI definition significantly increased the fit of the multivariate linear regression model. The new IDF/AHA/NHLBI definition of metabolic syndrome may have a stronger relationship with serum hsCRP than the IDF definition.

Plasminogen activator inhibitor type 1 (PAI-1) is a valuable biomarker for predicting the metabolic syndrome (MS) in institutionalized elderly residents in Taiwan

Circulating levels of inflammatory and prothrombotic factors are elevated in the metabolic syndrome (MS) and linked with the occurrence of cardiovascular events. The aim of our study was to investigate the relationship between inflammatory and prothrombotic markers and the MS in elderly institutionalized residents. A total of 326 non-diabetic residents of Chuang-Hua Veterans Care Home (age: 79.9+/-4.1 years; 100% males) were enrolled. MS was diagnosed according to the AHA/NHLBI Scientific Statement criteria. Body fat percentage was measured by bioelectrical impedance analysis. Insulin resistance was calculated by homeostasis model assessment for insulin resistance (HOMA-IR). Inflammatory markers, including tumor necrosis factor-a (TNF-alpha), high sensitivity C-reactive protein (hsCRP), and plasminogen activator inhibitor-1 (PAI-1), were determined using ELISA. Elderly residents with the MS had higher systolic and diastolic blood pressures (both p < 0.001) and higher HOMA-IR (p < 0.001), hsCRP (p = 0.008), and PAI-1 levels (p < 0.001) than those without the MS. On multivariate logistic regression analysis, PAI-1 was an independent risk factor for the MS. Of the MS components, elderly residents with higher waist circumferences and higher levels of plasma fasting glucose, and triglyceride (TG), and lower levels of high density lipoprotein (HDL) had higher PAI-1 levels than those without the above components.

Confirming a biological pathway in the metabolic syndrome--insight from the NHANES 1999-2002

The objective of this study was to examine the role of obesity in the development of the metabolic syndrome (MS). A total of 3,596 whites aged 19 years and above, who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2002, were included for analysis. Anthropometric measurements, biochemical profiles, and high-sensitivity C-reactive protein (CRP) were measured. A structural equation model (SEM) was constructed to elucidate a pathway in which obesity initiated the cascade leading to full MS. The results of SEM demonstrated that obesity was positively associated with elevated CRP level (B = 0.05, P < 0.001). This higher inflammatory state directed to insulin resistance (B = 0.32, P < 0.001), which in turn was positively associated with dyslipidemia (B = 0.06, P < 0.001). Obesity could also directly and positively affect blood pressure (B = 0.51, P < 0.001), without the mediation of insulin resistance and/or inflammation. The results of the cross-sectional analysis in the white subjects have shown that obesity has a strong influence on hypertension that obtains little additional influence from inflammation or insulin resistance. The metabolic profile in the NHANES group has been confirmatory with the statement that there is a sequential effect from obesity to inflammation, insulin resistance, and dyslipidemia. This approach has allowed to inferring important biological insights about the nature of the relationships among the components of MS.

Illustrating the roles of C-reactive protein in the development of the metabolic syndrome in women--a cross-racial validation

BACKGROUND AND AIMS

This study was designed to elucidate the role of C-reactive protein (CRP) as an inflammatory marker in the development of the metabolic syndrome (MS).

METHODS AND RESULTS

A total of 333 women without current medication attended an obesity-screening programme held in Yun-Lin, Taiwan. Anthropometric measurements were obtained; biochemical profiles, lipid profiles and high-sensitivity CRP (hsCRP) were measured. A structural equation model (SEM) was constructed to demonstrate that obesity might initiate the sequential pathway that leads to a pro-inflammatory state and other metabolic derangements. The results of SEM in the Taiwanese women showed that obesity was positively associated with elevated CRP (B=0.69, p<0.001). The pro-inflammatory state could result in insulin resistance (B=0.57, p<0.001), which in turn could lead to dyslipidaemia (B=0.46, p<0.01). The association between obesity and hypertension was positive and direct (B=0.43, p<0.01) without the intermediation of inflammation or insulin resistance. The implications could be reproduced when the same model was applied to the metabolic profiles of the Caucasian participants in the National Health and Nutrition Examination Survey 1999-2002.

CONCLUSION

Our study has demonstrated that obesity plays the central role in leading to hypertension and a pro-inflammatory state, insulin resistance and dyslipidaemia. The SEM has provided a comprehensive view to illustrate the complex interplay of the main components in the development of the MS, and this approach can be generalized to different populations.

C-reactive protein is directly related to plasminogen activator inhibitor type 1 (PAI-1) levels in diabetic subjects with the 4G allele at position -675 of the PAI-1 gene

BACKGROUND AND AIMS

C-reactive protein (CRP) has been identified as a possible factor able to promote atherosclerosis. "In vitro" studies have demonstrated that CRP induces plasminogen activator inhibitor type 1 (PAI-1) expression, suggesting a hypofibrinolytic role for CRP. As CRP and PAI-1 levels increase in type 2 diabetic subjects, we decided to study the relationship between CRP and PAI-1, and the role of the 4G/5G polymorphism of the PAI-1 gene on this relationship in a diabetic population without complications.

METHODS AND RESULTS

Two hundred and ninety-five type 2 diabetic patients (age 60.9+/-10.5 years) and 290 healthy controls (age 59.2+/-11.5 years) were enrolled. A significant correlation between PAI-1 and CRP in diabetic subjects was found (r=0.45, p<0.001), whereas no relationship was evident in the control subjects between these inflammatory markers. Multiple regression analysis highlighted that CRP is the only one significant variable of PAI-1 antigen in diabetic subjects (partial r=0.31, p<0.01). Stratifying by genotype, a positive correlation between PAI-1 and CRP in 4G/4G (partial r=0.64 p<0.001) and 4G/5G (partial r=0.47, p<0.001) subjects was found, whereas no correlation in 5G/5G was present. Multiple regression analysis confirmed the presence of this correlation in 4G/4G (partial r=0.45, p<0.001) and in 4G/5G (partial r=0.34, p=0.007) diabetic patients.

CONCLUSIONS

These findings demonstrate that CRP plays an important role in the complex mechanism regulating PAI-1 antigen in 4G diabetic carriers.

The relationship of gamma-glutamyltransferase to C-reactive protein and arterial stiffness

BACKGROUND AND AIMS

The relationships between gamma-glutamyltransferase (GGT), C-reactive protein (CRP), and arterial stiffness have not been fully investigated. The aim of this study was to clarify whether serum GGT is related to CRP and arterial stiffness estimated using brachial-ankle pulse wave velocity (baPWV).

METHODS AND RESULTS

The subjects were 3412 males and 854 females. GGT, CRP, baPWV, and conventional risk factors were evaluated. On multiple regression analysis, after adjustment for the conventional risk factors, log GGT was significantly associated with log CRP in male and female subjects (male subjects: beta=0.168, p<0.0001; female subjects: beta=0.098, p<0.05). After adjustment for the conventional risk factors, log GGT was significantly associated with PWV in male subjects (beta=0.060, p<0.0001), but in female subjects, no significant relationships were found after adjustment (beta=0.007, p=0.82).

CONCLUSION

These results suggest that GGT is independently associated with an increased level of CRP in both males and females. In addition, in males, GGT is related to an increased level of arterial stiffness.

The association of low-grade inflammation, urinary albumin, and insulin resistance with metabolic syndrome in nondiabetic Taiwanese

Metabolic syndrome, which involves different pathological mechanisms in associated disorders including inflammation, endothelial dysfunction, and insulin resistance, results in the development of cardiovascular diseases. The effect of the accumulative abnormalities of metabolic components and the relationship of each component to these associated disorders have not been clearly delineated. We therefore conducted a cross-sectional study to investigate the accumulative effect and the correlation of components of the metabolic syndrome to C-reactive protein (CRP), urinary albumin excretion (UAE), and the homeostasis model assessment for insulin resistance index (HOMA-IR). A total of 200 nondiabetic subjects received assessment of metabolic syndrome and measurements of serum CRP, UAE, and HOMA-IR. As the number of abnormalities of metabolic syndrome increased in subjects, the CRP, UAE, and HOMA-IR were significantly elevated (P value for trend less than .001, all). Waist circumference was an independent risk factor for CRP (P = .012); waist circumference and systolic blood pressure were independent risk factors for UAE (P = .010 and P < .001, respectively); and waist circumference, triglyceride, and glucose were independent risk factors for HOMA-IR (P < .001, all). More metabolic abnormalities were associated with higher risk of inflammation, urinary albumin, and insulin resistance. Waist circumference was the only independent risk factor for all 3 associated diseases in metabolic syndrome.

Increasing apoA-I production as a target for CHD risk reduction

Dyslipidemia leading to coronary heart diseases (CHD) enables venues to prevent or treat CHD by other strategies than only lowering serum LDL cholesterol (LDL-C) concentrations, which is currently the most frequently targeted change. Unlike LDL-C, elevated high-density lipoprotein cholesterol (HDL-C) concentrations may protect against the development of CHD as demonstrated in numerous large-scale epidemiological studies. In this review we describe that besides elevating serum HDL-C concentrations by increasing alpha-HDL particles, approaches to elevate HDL-C concentrations by increasing pre-beta HDL particle concentrations seems more attractive. Besides infusion of apoA-I(Milano), using apoA-I mimetics, or delipidation of alpha-HDL particles, elevating de novo apoA-I production may be a suitable target to functionally increase pre-beta HDL particle concentrations. Therefore, a detailed description of the molecular pathways underlying apoA-I synthesis and secretion, completed with an overview of known effects of pharmacological and nutritional compounds on apoA-I synthesis will be presented. This knowledge may ultimately be applied in developing dietary intervention strategies to elevate apoA-I production and serum HDL-C concentrations and consequently lower CHD risk.

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.

Magnesium and C-reactive protein in heart failure: an anti-inflammatory effect of magnesium administration?

BACKGROUND

Little is known about the relationship between serum magnesium (Mg) and C-reactive protein (CRP) in heart failure (HF).

AIM OF THE STUDY

To investigate the relationship, if any, between serum Mg and CRP in HF patients and, concomitantly, to test a hypothesis that Mg supplementation might affect serum CRP levels.

METHODS

Serum Mg and CRP were evaluated in 68 patients with chronic systolic HF leading to hospital admission and 65 patients requiring hospitalization for other causes. Following 5 weeks, serum Mg, CRP and intracellular Mg were reevaluated in 17 HF patients after administration of oral Mg citrate 300 mg/day (group A), and 18 untreated HF patients (group B). In order to obtain Gaussian distribution, logarithmic transformation of CRP was performed.

RESULTS

Inverse correlation was found between serum Mg and log CRP (r = -0.28, P = 0.002). Compared to controls, patients with HF demonstrated higher baseline CRP levels, independent of coexisting conditions, and lower serum Mg values. Following Mg treatment, log CRP decreased from 1.4 +/- 0.4 to 0.8 +/- 0.3 in group A (P < 0.001). No significant changes in log CRP were demonstrable in group B. Serum Mg (mmol/l) rose significantly in group A (0.74 +/- 0.04-0.88 +/- 0.08, P < 0.001), and to a lesser extent in group B (0.82 +/- 0.08-0.88 +/- 0.08, P = 0.04). Intracellular Mg significantly increased only in Mg-treated group A (P = 0.01).

CONCLUSIONS

Oral Mg supplementation to HF patients significantly attenuates blood levels of CRP, a biomarker of inflammation. Targeting the inflammatory cascade by Mg administration might prove a useful tool for improving the prognosis in HF.

Inflammatory process in type 2 diabetes: The role of cytokines

Population-based studies have shown strong relationship between inflammatory markers and metabolic disturbances, obesity, and atherosclerosis, whereas inflammation has been considered as a "common soil" between these clinical entities and type 2 diabetes (T2D). The accumulation of macrophages in adipose tissue (AT), the common origin of macrophages and adipocytes, the prevalent presence of peripheral mononuclear cells, and apoptotic beta cells by themselves seem to be the sources of inflammation present in T2D, since they generate the mediators of the inflammatory processes, namely cytokines. The main cytokines involved in the pathogenesis of T2D are interleukin-1beta (IL-1beta), with an action similar to the one present in type 1 diabetes, tumor necrosis factor-alpha (TNF-alpha), and IL-6, considered as the main regulators of inflammation, leptin, more recently introduced, and several others, such as monocyte chemoattractant protein-1, resistin, adiponectin, with either deleterious or beneficial effects in diabetic pathogenesis. The characterization of these molecules targeted diabetes treatment beyond the classical interventions with lifestyle changes and pharmaceutical agents, and toward the determination of specific molecular pathways that lead to low grade chronic inflammatory state mainly due to an immune system's unbalance.

β

PURPOSE

This study was designed to illustrate the effects of C-reactive protein (CRP) and interleukin polymorphisms on serum CRP levels.

METHODS

A total of 390 patients with coronary heart disease (CHD) were recruited and high-sensitivity CRP levels were measured. Six polymorphic alleles on the genes of CRP, IL-1, and the IL-1 receptor antagonist were identified. A classification tree was applied to determine their effects and interactions on serum CRP levels.

RESULTS

In the hypertensive CHD patients, the presence of CRP + 1059 GC heterozygotes was associated with a lower risk for elevated CRP levels (OR = 0.318, P = 0.001). The coexistence of CRP + 1059 GC and IL-1beta-511 (CT or TT) might result in reduction in the CRP levels compared to IL-1beta-511 CC (OR = 0.222, P = 0.088 and OR = 0.148, P = 0.060, respectively).

CONCLUSION

The results demonstrated the distribution of CRP-related polymorphisms and the interactions in Taiwanese patients with CHD.

The dysregulated adipose tissue: a connecting link between insulin resistance, type 2 diabetes mellitus and atherosclerosis

An emerging paradigm supports the view that adipose tissue (AT) dysregulation might play a crucial role in the pathogenesis of insulin-resistance and atherosclerosis. The net result of such a dysregulation is a state of low-grade, chronic, systemic inflammation that, in turn, links both the metabolic and the vascular pathologies. Overwhelming evidence shows that high circulating levels of markers of chronic inflammation predict the development of T2DM and atherosclerotic manifestations. Therefore, atherosclerotic cardiovascular disease and T2DM seem to arise from a "common soil", and chronic inflammation is a candidate. In this scenario, the dysfunctional AT provide a common hallmark for these apparently divergent disorders. An important question then is whether dysregulated and inflamed AT can be converted to healthy fat and, consequently, the development or the progression of metabolic and vascular impairment can be prevented or reversed by the modulation of the inflammatory profile. The beneficial effects of weight loss on obesity-related complications are clearly associated with the modification of the inflammatory profile in the AT. Furthermore, the thiazolidinediones (TZDs) possess both anti-inflammatory and anti-atherogenic properties. Intriguingly, in contrast to the paradoxical weight gain, TZDs influence favorably the pattern of adipokines. In conclusion, accepting the paradigm of AT dysfunction, the use of TZDs will represent an additional therapeutic approach that, in association with lifestyle interventions, would improve inflammation, ameliorate insulin sensitivity, and alleviate the related risk of atherosclerosis.