Relationship between metabolic syndrome, insulin resistance and C-reactive protein in urban Korean adult population

Lee, Won Young; Park, Jeong Sik; Sung, Ki Chul; Kim, Bum Soo; Kang, Jin Ho; Kim, Sun Woo; Lee, Man Ho; Park, Jung Ro

Abstract

BACKGROUND: Increased C-reactive protein (CRP), very sensitive acute phase reactant, is an independent risk factor for coronary artery disease. However, the relationship between insulin resistance and CRP has not been thoroughly studied. We intended to observe the association between metabolic syndrome, insulin resistance and CRP, thus identify the role of CRP in the atherosclerosis and insulin resistance.
METHODS
Total 767 subjects (436 men, 331 women) who underwent medical check-up at health promotion center in Kangbuk Samsung Hospital during March 2002, aged 20-84 years (mean+/-SD: 47.3+/-11.2), were included in this study. Age, sex, height, body weight, waist circumference, blood pressure, blood cholesterol, triglyceride, HDL cholesterol, and fasting glucose levels were measured. HOMA (Homeostasis model assessment index) and QUICKI (quantitative insulin sensitivity check index) were calculated and the correlations between indices of insulin resistance and CRP were evaluated.
RESULTS
The mean concentrations of CRP in subjects according to the presence of 0, 1, 2, 3, 4, 5 features of metabolic syndrome defined by NCEP-ATP III were 0.64, 0.95, 1.14, 1.19, 2.40, 2.53 mg/L, respectively. The mean concentrations of CRP were significantly higher in subjects with higher insulin resistance (high HOMA index and lower QUICKI) compared to those with lower insulin resistance (p<0.01). In the group with the highest quartile of CRP (CRP>or=1.1 mg/L), the waist circumference, triglyceride, blood pressure and glucose levels were significantly higher and the HDL cholesterol level was significantly lower than the group with the lowest quartile of CRP (CRP<0.2 mg/L, p<0.01). There was a statistically significant positive correlation between CRP and BMI, waist circumference, triglyceride, blood pressure, glucose and HOMA index. A significant negative correlation was found between CRP and HDL cholesterol and QUICKI (above all p<0.001).
CONCLUSION
These data suggest that metabolic syndrome and insulin resistance are associated with systemic inflammatory response, which plays an important pathogenetic role in atherosclerosis. Therefore, early diagnosis and tight control of metabolic syndrome should be administered for the prevention of cardiovascular events.