title: Insulin resistance in Chinese patients with type 2 diabetes is associated with C-reactive protein independent of abdominal obesity.
abstract: BACKGROUND
  There is debate as to whether the association between C-reactive protein (CRP) and insulin resistance is independent of body fatness, particularly central obesity. Therefore, the association among CRP, insulin resistance and obesity was analyzed in Chinese patients with type 2 diabetes.
  
  
  METHODS
  The study included 520 Chinese patients diagnosed with type 2 diabetes with CRP levels not exceeding 10 mg/L. The degree of insulin resistance was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). The CRP levels were categorized into quartiles from the lowest to the highest concentrations (Q1-Q4).
  
  
  RESULTS
  Body mass index (BMI) and waist circumference (WC) were both higher in Q4, Q3 and Q2 than those in Q1. HOMA-IR was higher in Q2, Q3 and Q4 than that in Q1 (Q1 vs Q4, P < 0.001; Q1 vs Q3, P < 0.001; Q1 vs Q2, P = 0.028). Log CRP was significantly correlated with log HOMA-IR (correlation coefficient: 0.230, P < 0.001) and BMI (correlation coefficient: 0.305, P < 0.001) and WC (correlation coefficient: 0.240, P < 0.001) by Spearman correlation analysis. Multiple linear regression analysis adjusting for age, gender and components of metabolic syndrome, log CRP was also independently associated with log HOMA-IR (β coefficient, 0.168; P < 0.001) and WC (β coefficient, 0.131; P = 0.006).
  
  
  CONCLUSIONS
  These findings showed that insulin resistance was associated with CRP levels independent of abdominal obesity in Chinese patients with type 2 diabetes, suggesting that abdominal obesity could only partly explain the link between subclinical inflammation and insulin resistance.
authors.affiliation: Department of Endocrinology and Metabolism, HuaShan Hospital, Shanghai 200040, PR China.
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.forename: Yehong
authors.initials: Y
authors.lastname: Yang
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Yang
authors.forename: Xiaocheng
authors.initials: X
authors.lastname: Feng
authors.forename: Xuanchun
authors.initials: X
authors.lastname: Wang
authors.forename: Zhaoyun
authors.initials: Z
authors.lastname: Zhang
authors.forename: Renming
authors.initials: R
authors.lastname: Hu
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000276:immunology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000208:ethnology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000208:ethnology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference / Q000208:ethnology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D007328:Insulin; C517652:hemoglobin A1c protein, human