title: The metabolic syndrome and insulin resistance: relationship to haemostatic and inflammatory markers in older non-diabetic men.
abstract: OBJECTIVE
  We have examined the cross-sectional relationship between insulin resistance, the metabolic syndrome and haemostatic and inflammatory markers.
  
  
  RESULTS
  We carried out the study in 2722 non-diabetic men aged 60-79 years with no history of coronary heart disease or stroke and who were not on warfarin treatment, drawn from general practices in 24 British towns. Insulin resistance (HOMA) was significantly associated with increased inflammatory markers (C-reactive protein (CRP), white cell count), coagulation factors VII-IX, von Willebrand factor (VWF) and tissue plasminogen activator (t-PA) antigens (markers of endothelial dysfunction) and blood viscosity after adjustment for age, smoking, physical activity, alcohol intake and waist circumference. Relationships with fibrinogen and fibrin D-dimer were weak. The relationship between HOMA and CRP was abolished after adjustment for t-PA. The prevalence of the metabolic syndrome was similar using World Health Organization (WHO) and National Cholesterol Education Program definitions (26.7% and 27.0%) but associations between the metabolic syndrome and increased haemostatic markers, particularly for raised factor VIII and VWF were stronger using WHO criteria.
  
  
  CONCLUSIONS
  Insulin resistance and the metabolic syndrome showed significant associations with markers of haemostasis and inflammation, which may be relevant to their associations with cardiovascular disease.
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK. goya@pcps.ucl.ac.uk
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.forename: Gordon D O
authors.initials: GD
authors.lastname: Lowe
authors.forename: A Gerald
authors.initials: AG
authors.lastname: Shaper
authors.forename: Ann
authors.initials: A
authors.lastname: Rumley
authors.forename: Lucy
authors.initials: L
authors.lastname: Lennon
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001779:Blood Coagulation Factors / Q000378:metabolism; D001809:Blood Viscosity; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005169:Factor VIII / Q000378:metabolism; D006487:Hemostasis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007333:Insulin Resistance; D007958:Leukocyte Count; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies; D010959:Tissue Plasminogen Activator / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D014841:von Willebrand Factor; D005169:Factor VIII; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator