C-reactive protein, metabolic syndrome, and insulin resistance in individuals with spinal cord injury.
OBJECTIVE
High-sensitivity C-reactive protein (hsCRP) has been shown to be indicative of elevated risk of cardiovascular disease (CVD). We examined this blood marker in persons with spinal cord injury (SCI) in order to determine its potential for predicting elevated cardiac risk.


METHODS
In a cross-sectional analysis, we examined the relationship between hsCRP and insulin resistance and metabolic syndrome among 93 individuals with SCI (50.2 +/- 13 years). Fasting lipids, insulin, glucose, plasma hsCRP, and anthropometric data were gathered from each subject. Comparisons were made with population reference values.


RESULTS
Metabolic syndrome and insulin resistance were present in nearly one quarter of the SCI population (22.6%). Subjects with fasting insulin resistance had significantly higher mean hsCRP (4.29 +/- 3.25 mg/L) than those who were not insulin resistant (2.24 +/- 2.02) (P < 0.05). Moreover, hsCRP was significantly elevated in individuals who presented with high cardiovascular risk including severe dyslipidemia (> or = 4 abnormal lipid values) and Framingham Risk scores < or = 6 (P < 0.05 for both values). In addition, the homeostasis model assessment of insulin resistance was mildly correlated with hsCRP (r = 0.33).


CONCLUSIONS
In individuals with SCI who are insulin resistant and/or display components of the metabolic syndrome, hsCRP is elevated suggesting a clinically important association with cardiovascular risk in this population.
Lee
Matthew Y
MY
Spinal Cord Injury Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA. matthewylee@yahoo.com
Myers
Jonathan
J
Hayes
Amy
A
Madan
Sherna
S
Froelicher
Victor F
VF
Perkash
Inder
I
Kiratli
B Jenny
BJ
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000097:blood* / Q000150:complications
D015415:Biomarkers; D008055:Lipids; D002097:C-Reactive Protein