Metabolic syndrome, insulin resistance and the inflammation markers C-reactive protein and ferritin.
BACKGROUND
Patients with metabolic syndrome (MS) have above-average risk of developing atherosclerosis and cardiovascular disease. Inflammation plays a key role in the development of atherosclerosis. High levels of the acute phase reactants C-reactive protein (CRP) and ferritin have been reported to correlate with various components of MS.


METHODS
The serum CRP, ferritin, glucose, insulin, triglycerides, HDL-cholesterol and total cholesterol concentrations of 598 obese or overweight patients were determined, together with relevant anthropometric parameters. Insulin resistance was evaluated by the HOMA method. MS was diagnosed using the ATP III criteria.


RESULTS
CRP levels were higher among patients with central obesity than in those without (5.8 vs 3.9 mg/l; P=0.003), and higher among those with fasting plasma glucose concentrations >or=110 mg/dl than in those with lower concentrations (7.4 vs 4.1 mg/l; P=0.01). Serum ferritin levels were higher among patients with triglyceride concentrations >or=150 mg/dl than in those with lower levels (76.8 vs 40.1 ng/ml; P<0.001), and higher among those with fasting plasma glucose concentrations >or=110 mg/dl than in those with lower concentrations (75.7 vs 41.7 ng/ml; P=0.005). The number of MS criteria that were satisfied increased with CRP and ferritin levels. Patients with insulin resistance also had higher CRP and ferritin levels than those without, 7.3 vs 4.3 mg/l for CRP (P=0.032) and 124.5 vs 80.1 ng/ml for ferritin (P<0.001).


CONCLUSIONS
MS and insulin resistance are associated with elevated serum CRP and ferritin. Evaluation of subclinical chronic inflammation in patients with MS and/or insulin resistance by determination of these markers might aid in their evaluation as candidates for aggressive intervention against cardiovascular risk factors.
Endocrinology and Nutrition Service, Juan Canalejo Hospital, La Coruña, Spain. Asoto@canalejo.org
A Soto
AS
González
D Bellido
DB
Guerrero
M Buño
MB
Soto
S Pértega
SP
Díaz
M
M
Martinez-Olmos
O
O
Vidal
D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood; D006973:Hypertension / Q000097:blood; D007249:Inflammation / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000209:etiology / Q000378:metabolism; D009765:Obesity / Q000097:blood / Q000150:complications / Q000378:metabolism*; D012372:ROC Curve; D012307:Risk Factors
D015415:Biomarkers; D002097:C-Reactive Protein; D005293:Ferritins