Skip to main content
SpringerLink
Log in

High-Sensitivity C-Reactive Protein and the Metabolic Syndrome

  • Chapter
Book cover The Metabolic Syndrome

Part of the book series: Contemporary Endocrinology ((COE))

  • 1516 Accesses

Abstract

Elevated levels of C-reactive protein (CRP) well below the conventional clinical upper limit of 10 mg/L (as measured by high-sensitivity CRP) have been shown to be a strong predictor of incident type 2 diabetes and cardiovascular events. Low-grade chronic inflammation, as reflected by elevated high-sensitivity CRP, may be one of the common antecedents underlying the clustering of obesity, impaired glucose tolerance, dyslipidemia, and hypertension, known as the metabolic syndrome. This article aims to summarize epidemiological data on the relation between CRP and features of the conventionally defined metabolic syndrome. The available evidence indicates that CRP levels correlate not only with each of the metabolic syndrome components individually, but also with the metabolic syndrome as an entity. Furthermore, CRP appears to add independent prognostic information across all levels of the metabolic syndrome, indicating the clinical value of CRP for prediction of cardiovascular disease and diabetes. Future studies are warranted to assess the predictive values of combining CRP and the metabolic syndrome in the risk assessment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Black S, Kushner I, Samols D. C-reactive Protein. J Biol Chem 2004; 279:48487–48490.

    Article  CAS  PubMed  Google Scholar 

  2. Volanakis JE. Human C-reactive protein: expression, structure, and function. Mol Immunol 2001; 38:189–197.

    Article  CAS  PubMed  Google Scholar 

  3. Tillett WS, Francis T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med 1930; 52:561–571.

    Article  CAS  PubMed  Google Scholar 

  4. Pepys MB, Hirschfield GM. C-reactive protein: A critical update. J Clin Invest 2003; 111:1805–1812.

    CAS  PubMed  Google Scholar 

  5. Pankow JS, Folsom AR, Cushman M, Borecki IB, Hopkins PN, Eckfeldt JH, Tracy RP. Familial and genetic determinants of systemic markers of inflammation: The NHLBI family heart study. Atherosclerosis 2001; 154:681–689.

    Article  CAS  PubMed  Google Scholar 

  6. Vickers MA, Green FR, Terry C, Mayosi BM, Julier C, Lathrop M, Ratcliffe PJ, Watkins HC, Keavney B. Genotype at a promoter polymorphism of the interleukin-6 gene is associated with baseline levels of plasma C-reactive protein. Cardiovasc Res 2002; 53:1029–1034.

    Article  CAS  PubMed  Google Scholar 

  7. Miller DT, Zee RY, Suk Danik J, Kozlowski P, Chasman DI, Lazarus R, Cook NR, Ridker PM, Kwiatkowski DJ. Association of common CRP gene variants with CRP levels and cardiovascular events. Ann Hum Genet 2005; 69:623–638.

    Article  CAS  PubMed  Google Scholar 

  8. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105: 1135–1143.

    Article  CAS  PubMed  Google Scholar 

  9. Ross R. Atherosclerosis: An inflammatory disease. N Engl J Med 1999; 340:115–126.

    Article  CAS  PubMed  Google Scholar 

  10. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). lAMA 2001; 285:2486–2497.

    Google Scholar 

  11. Cermak J, Key NS, Bach RR, Balla J, Jacob HS, Vercellotti GM. C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood 1993; 82:513–520.

    CAS  PubMed  Google Scholar 

  12. Devaraj S, Xu DY, Jialal I. C-reactive protein increases plasminogen activator inhibitor-1 expression and activity in human aortic endothelial cells: Implications for the metabolic syndrome and atherothrombosis. Circulation 2003; 107:398–404.

    Article  CAS  PubMed  Google Scholar 

  13. Pasceri V, Cheng JS, Willerson JT, Yeh ET. Modulation of C-reactive protein-mediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drugs. Circulation 2001; 103:2531–2534.

    CAS  PubMed  Google Scholar 

  14. Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000; 102:2165–2168.

    CAS  PubMed  Google Scholar 

  15. Venugopal SK, Devaraj S, Yuhanna I, Shaul P, Jialal I. Demonstration that C-reactive protein decreases eNOS expression and bioactivity in human aortic endothelial cells. Circulation 2002; 106:1439–1441.

    Article  CAS  PubMed  Google Scholar 

  16. Verma S, Badiwala MV, Weisel RD, Li SH, Wang CH, Fedak PW, Li RK, Mickle DA. C-reactive protein activates the nuclear factor-kappaB signal transduction pathway in saphenous vein endothelial cells: Implications for atherosclerosis and restenosis. J Thorac Cardiovasc Surg 2003; 126: 1886–1891.

    Article  CAS  PubMed  Google Scholar 

  17. Verma S, Kuliszewski MA, Li SH, Szmitko PE, Zucco L, Wang CH, Badiwala MV, Mickle DA, Weisel RD, Fedak PW, Stewart DJ, Kutryk MJ. C-reactive protein attenuates endothelial progenitor cell survival, differentiation, and function: Further evidence of a mechanistic link between C-reactive protein and cardiovascular disease. Circulation 2004; 109:2058–2067.

    Article  CAS  PubMed  Google Scholar 

  18. Verma S, Li SH, Badiwala MV, Weisel RD, Fedak PW, Li RK, Dhillon B, Mickle DA. Endothelin antagonism and interleukin-6 inhibition attenuate the proatherogenic effects of C-reactive protein. Circulation 2002; 105:1890–1896.

    Article  CAS  PubMed  Google Scholar 

  19. Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV, Dhillon B, Weisel RD, Li RK, Mickle DA, Stewart DJ. A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 2002; 106:913–919.

    Article  CAS  PubMed  Google Scholar 

  20. Wang CH, Li SH, Weisel RD, Fedak PW, Dumont AS, Szmitko P, Li RK, Mickle DA, Verma S. Creactive protein upregulates angiotensin type 1 receptors in vascular smooth muscle. Circulation 2003; 107:1783–1790.

    Article  CAS  PubMed  Google Scholar 

  21. Zwaka TP, Hombach V, Torzewski J. C-reactive protein-mediated low density lipoprotein uptake by macrophages: Implications for atherosclerosis. Circulation 2001; 103:1194–1197.

    CAS  PubMed  Google Scholar 

  22. Danenberg HD, Szalai AJ, Swaminathan RV, Peng L, Chen Z, Seifert P, Fay WP, Simon DI, Edelman ER. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice. Circulation 2003; 108:512–515.

    Article  CAS  PubMed  Google Scholar 

  23. Paul A, Ko KW, Li L, Yechoor V, McCrory MA, Szalai AJ, Chan L. C-reactive protein accelerates the progression of atherosclerosis in apolipoprotein E-deficient mice. Circulation 2004; 109:647–655.

    Article  CAS  PubMed  Google Scholar 

  24. Trion A, de Maat MP, Jukema JW, van der Laarse A, Maas MC, Offerman EH, Havekes LM, Szalai AJ, Princen HM, Emeis JJ. No effect of C-reactive protein on early atherosclerosis development in apolipoprotein E*3-leidenlhuman C-reactive protein transgenic mice. Arterioscler Thromb Vasc Biol 2005; 25:1635–1640.

    Article  CAS  PubMed  Google Scholar 

  25. Hirschfield GM, Gallimore JR, Kahan MC, Hutchinson WL, Sabin CA, Benson GM, Dhillon AP, Tennent GA, Pepys MB. Transgenic human C-reactive protein is not proatherogenic in apolipoprotein E-deficient mice. Proc Natl Acad Sci USA 2005; 102:8309–8314.

    Article  CAS  PubMed  Google Scholar 

  26. Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: Meta-analyses of prospective studies. lAMA 1998; 279:1477–1482.

    CAS  Google Scholar 

  27. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342:836–843.

    Article  CAS  PubMed  Google Scholar 

  28. Festa A, D’ Agostino R, Jr., Tracy RP, Haffner SM. Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: The insulin resistance atherosclerosis study. Diabetes 2002; 51:1131–1137.

    Article  CAS  PubMed  Google Scholar 

  29. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001; 286:327–334.

    Article  CAS  PubMed  Google Scholar 

  30. Schmidt MI, Duncan BB, Sharrett AR, Lindberg G, Savage PJ, Offenbacher S, Azambuja MI, Tracy RP, Heiss G. Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities study): A cohort study. Lancet 1999; 353:1649–1652.

    Article  CAS  PubMed  Google Scholar 

  31. Thorand B, Lowel H, Schneider A, Kolb H, Meisinger C, Frohlich M, Koenig W. C-reactive protein as a predictor for incident diabetes mellitus among middle-aged men: Results from the MONICA Augsburg cohort study, 1984–1998. Arch Intern Med 2003; 163:93–99.

    Article  CAS  PubMed  Google Scholar 

  32. Ridker PM. High-sensitivity C-reactive protein: Potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation 2001; 103:1813–1818.

    CAS  PubMed  Google Scholar 

  33. Rifai N, Ridker PM. High-sensitivity C-reactive protein: A novel and promising marker of coronary heart disease. Clin Chern 2001; 47:403–411.

    CAS  Google Scholar 

  34. Meier-Ewert HK, Ridker PM, Rifai N, Price N, Dinges DF, Mullington JM. Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chern 2001; 47:426–430.

    CAS  Google Scholar 

  35. Ockene IS, Matthews CE, Rifai N, Ridker PM, Reed G, Stanek E. Variability and classification accuracy of serial high-sensitivity C-reactive protein measurements in healthy adults. Clin Chern 2001; 47:444–450.

    CAS  Google Scholar 

  36. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, 3rd, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC, Jr., Taubert K, Tracy RP, Vinicor F. Markers of inflammation and cardiovascular disease-application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003; 107:499–511.

    Article  PubMed  Google Scholar 

  37. Rifai N, Ridker PM. Population distributions of C-reactive protein in apparently healthy men and women in the United States: Implication for clinical interpretation. Clin Chern 2003; 49:666–669.

    Article  CAS  Google Scholar 

  38. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome: A comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 111:1448–1454.

    Article  PubMed  Google Scholar 

  39. Ridker PM, Wilson PW, Grundy SM. Should C-reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk? Circulation 2004; 109:2818–2825.

    Article  CAS  PubMed  Google Scholar 

  40. Mohamed-Ali V, Pinkney JH, Coppack SW. Adipose tissue as an endocrine and paracrine organ. Int JObes Relat Metab Disord 1998; 22:1145–1158.

    Article  CAS  Google Scholar 

  41. Mendall MA, Patel P, Asante M, Ballam L, Morris J, Strachan DP, Camm AJ, Northfield TC. Relation of serum cytokine concentrations to cardiovascular risk factors and coronary heart disease. Heart 1997; 78:273–277.

    CAS  PubMed  Google Scholar 

  42. Tracy RP, Psaty B M, Macy E, Bovill EG, Cushman M, Cornell ES, Kuller LH. Lifetime smoking exposure affects the association of C-reactive protein with cardiovascular disease risk factors and subclinical disease in healthy elderly subjects. Arterioscler Thromb Vase Biol 1997; 17:2167–2176.

    CAS  Google Scholar 

  43. Forouhi NG, Sattar N, McKeigue PM. Relation of C-reactive protein to body fat distribution and features of the metabolic syndrome in Europeans and South Asians. Int JObes Relat Metab Disord 2001; 25:1327–1331.

    Article  CAS  Google Scholar 

  44. Pannacciulli N, Cantatore FP, Minenna A, Bellacicco M, Giorgino R, De Pergola G. C-reactive protein is independently associated with total body fat, central fat, and insulin resistance in adult women.Int JObes Relat Metab Disord 2001; 25:1416–1420.

    Article  CAS  Google Scholar 

  45. Santos AC, Lopes C, Guimaraes JT, Barros H. Central obesity as a major determinant of increased high-sensitivity C-reactive protein in metabolic syndrome. Int JObes (Lond) 2005; 29:14521456.

    Google Scholar 

  46. Lear SA, Chen MM, Birmingham CL, Frohlich JJ. The relationship between simple anthropometric indices and C-reactive protein: ethnic and gender differences. Metabolism 2003; 52:1542–1546.

    Article  CAS  PubMed  Google Scholar 

  47. Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subject-associations with obesity, insulin resistance, and endothelial dysfunction: A potential role for cytokines originating from adipose tissue? Arterioseler Thromb Vase Biol 1999; 19:972–978.

    CAS  Google Scholar 

  48. Festa A, D’ Agostino R, Jr., Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM. The relation of body fat mass and distribution to markers of chronic inflammation. Int JObes RelatMetab Disord 2001; 25:1407–1415.

    Article  CAS  Google Scholar 

  49. Lemieux I, Pascot A, Prud’homme D, Almeras N, Bogaty P, Nadeau A, Bergeron J, Despres JP. Elevated C-reactive protein: Another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vase Biol 2001; 21:961–967.

    CAS  Google Scholar 

  50. Bermudez EA, Rifai N, Buring J, Manson JE, Ridker PM. Interrelationships among circulating interleukin-6, C-reactive protein, and traditional cardiovascular risk factors in women. Arterioseler Thromb Vase Biol 2002; 22:1668–1673.

    Article  CAS  Google Scholar 

  51. Barinas-Mitchell E, Cushman M, Meilahn EN, Tracy RP, Kuller LH. Serum levels of C-reactive protein are associated with obesity, weight gain, and hormone replacement therapy in healthy postmenopausal women. Am J Epidemiol 2001; 153:1094–1101.

    Article  CAS  PubMed  Google Scholar 

  52. Rexrode KM, Pradhan A, Manson JE, Buring JE, Ridker PM. Relationship of total and abdominal adiposity with CRP and IL-6 in women. Ann Epidemiol 2003; 13:674–682.

    Article  PubMed  Google Scholar 

  53. Saito I, Yonemasu K, Inami F. Association of body mass index, body fat, and weight gain with inflammation markers among rural residents in Japan. Circ J 2003; 67:323–329.

    Article  PubMed  Google Scholar 

  54. Nakanishi N, Shiraishi T, Wada M. Association between fasting glucose and C-reactive protein in a Japanese population: The Minoh study. Diabetes Res Clin Praet 2005; 69:88–98.

    Article  CAS  Google Scholar 

  55. Lim S, Lee HK, Kimm KC, Park C, Shin C, Cho NH. C-reactive protein level as an independent risk factor of metabolic syndrome in the Korean population: CRP as risk factor of metabolic syndrome. Diabetes Res Clin Praet 2005; 70:126–133.

    Article  CAS  Google Scholar 

  56. Connelly PW, Hanley AJ, Harris SB, Hegele RA, Zinman B. Relation of waist circumference and glycemic status to C-reactive protein in the Sandy Lake Oji-Cree. Int JObes Relat Metab Disord 2003; 27:347–354.

    Article  CAS  Google Scholar 

  57. Festa A, Hanley AJ, Tracy RP, D’ Agostino R Jr, Haffner SM. Inflammation in the prediabetic state is related to increased insulin resistance rather than decreased insulin secretion. Circulation 2003; 108:1822–1830.

    Article  CAS  PubMed  Google Scholar 

  58. Ford ES. Body mass index, diabetes, and C-reactive protein among u.S. adults. Diabetes Care 1999; 22:1971–1977.

    Article  CAS  PubMed  Google Scholar 

  59. Ford ES, Galuska DA, Gillespie C, Will JC, Giles WH, Dietz WH. C-reactive protein and body mass index in children: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. J Pediatr 2001; 138:486–492.

    Article  CAS  PubMed  Google Scholar 

  60. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999; 282:2131–2135.

    Article  CAS  PubMed  Google Scholar 

  61. Han TS, Sattar N, Williams K, Gonzalez-Villalpando C, Lean ME, Haffner SM. Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes Care 2002; 25:2016–2021.

    Article  CAS  PubMed  Google Scholar 

  62. Festa A, D’ Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: The Insulin Resistance Atherosclerosis Study (lRAS). Circulation 2000; 102:42–47.

    CAS  PubMed  Google Scholar 

  63. Thorand B, Baumert J, Doring A, Herder C, Kolb H, Rathmann W, Giani G, Koenig W. Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis 2006; 184:216–224.

    Article  CAS  PubMed  Google Scholar 

  64. Sites CK, Toth MJ, Cushman M, L’Hommedieu GD, Tchernof A, Tracy RP, Poehlman ET. Menopause-related differences in inflammation markers and their relationship to body fat distribution and insulin-stimulated glucose disposal. Fertil Steril 2002; 77: 128–135.

    Article  PubMed  Google Scholar 

  65. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004; 89:2548–2556.

    Article  CAS  PubMed  Google Scholar 

  66. Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 2000; 21:697–738.

    Article  CAS  PubMed  Google Scholar 

  67. Mayes JS, Watson GH. Direct effects of sex steroid hormones on adipose tissues and obesity. Obes Rev 2004; 5:197–216.

    Article  CAS  PubMed  Google Scholar 

  68. Pfeilschifter J, Koditz R, Pfohl M, Schatz H. Changes in proinflammatory cytokine activity after menopause. Endocr Rev 2002; 23:90–119.

    Article  CAS  PubMed  Google Scholar 

  69. Shuldiner AR, Yang R, Gong DW. Resistin, obesity and insulin resistance: The emerging role of the adipocyte as an endocrine organ. N Engl J Med 2001; 345:1345–1346.

    Article  CAS  PubMed  Google Scholar 

  70. Engeli S, Feldpausch M, Gorzelniak K, Hartwig F, Heintze U, Janke J, Mohlig M, Pfeiffer AF, Luft FC, Sharma AM. Association between adiponectin and mediators of inflammation in obese women. Diabetes 2003; 52:942–947.

    Article  CAS  PubMed  Google Scholar 

  71. Krakoff J, Funahashi T, Stehouwer CD, Schalkwijk CG, Tanaka S, Matsuzawa Y, Kobes S, Tataranni PA, Hanson RL, Knowler WC, Lindsay RS. Inflammatory markers, adiponectin, and risk of type 2 diabetes in the Pima Indian. Diabetes Care 2003; 26:1745–1751.

    Article  CAS  PubMed  Google Scholar 

  72. Mantzoros CS, Li T, Manson JE, Meigs JB, Hu FB. Circulating adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in women with type 2 diabetes. J Clin Endocrinol Metab 2005; 90:4542–4548.

    Article  CAS  PubMed  Google Scholar 

  73. Matsushita K, Yatsuya H, Tamakoshi K, Wada K, Otsuka R, Zhang H, Sugiura K, Kondo T, Murohara T, Toyoshima H. Inverse association between adiponectin and C-reactive protein in substantially healthy Japanese men. Atherosclerosis 2006; 188:184–189.

    Article  CAS  PubMed  Google Scholar 

  74. Ouchi N, Kihara S, Funahashi T, Nakamura T, Nishida M, Kumada M, Okamoto Y, Ohashi K, Nagaretani H, Kishida K, Nishizawa H, Maeda N, Kobayashi H, Hiraoka H, Matsuzawa Y. Reciprocal association of C-reactive protein with adiponectin in blood stream and adipose tissue. Circulation 2003; 107:671–674.

    Article  CAS  PubMed  Google Scholar 

  75. Rothenbacher D, Brenner H, Marz W, Koenig W. Adiponectin, risk of coronary heart disease and correlations with cardiovascular risk markers. Eur Heart J 2005; 26:1640–1646.

    Article  CAS  PubMed  Google Scholar 

  76. Schulze MB, Rimm EB, Shai I, Rifai N, Hu FB. Relationship between adiponectin and glycemic control, blood lipids, and inflammatory markers in men with type 2 diabetes. Diabetes Care 2004; 27:1680–1687.

    Article  CAS  PubMed  Google Scholar 

  77. Shetty GK, Economides PA, Horton ES, Mantzoros CS, Veves A. Circulating adiponectin and resistin levels in relation to metabolic factors, inflammatory markers, and vascular reactivity in diabetic patients and subjects at risk for diabetes. Diabetes Care 2004; 27:2450–2457.

    Article  CAS  PubMed  Google Scholar 

  78. Winzer C, Wagner O, Festa A, Schneider B, Roden M, Bancher-Todesca D, Pacini G, Funahashi T, Kautzky-Willer A. Plasma adiponectin, insulin sensitivity, and subclinical inflammation in women with prior gestational diabetes mellitus. Diabetes Care 2004; 27:1721–1727.

    Article  CAS  PubMed  Google Scholar 

  79. Al-Daghri N, Chetty R, McTernan PG, Al-Rubean K, Al-Attas O, Jones AF, Kumar S. Serum resistin is associated with c-reactive protein & ldl cholesterol in type 2 diabetes and coronary artery disease in a Saudi population. Cardiovasc Diabetol 2005; 4: 10.

    Article  CAS  PubMed  Google Scholar 

  80. Bo S, Gambino R, Pagani A, Guidi S, Gentile L, Cassader M, Pagano GF. Relationships between human serum resistin, inflammatory markers and insulin resistance. Int J Obes (Lond) 2005; 29:1315–1320.

    Article  CAS  Google Scholar 

  81. Heilbronn LK, Noakes M, Clifton PM. Energy restriction and weight loss on very-low-fat diets reduce C-reactive protein concentrations in obese, healthy women. Arterioscler Thromb Vase Biol 2001; 21:968–970.

    CAS  Google Scholar 

  82. Tchernof A, Nolan A, Sites CK, Ades PA, Poehlman ET. Weight loss reduces C-reactive protein levels in obese postmenopausal women. Circulation 2002; 105:564–569.

    Article  PubMed  Google Scholar 

  83. Pradhan AD, Cook NR, Buring JE, Manson JE, Ridker PM. C-reactive protein is independently associated with fasting insulin in nondiabetic women. Arterioscler Thromb Vasc Biol 2003; 23:650–655.

    Article  CAS  PubMed  Google Scholar 

  84. Wu T, Dorn JP, Donahue RP, Sempos CT, Trevisan M. Associations of serum C-reactive protein with fasting insulin in nondiabetic women. Arterioscler Thromb Vasc Biol 2003; 23:650–655.

    Article  CAS  Google Scholar 

  85. Wu T, Dorn JP, Donahue RP, Sempos CT, Trevisan M. Associations of serum C-reactive protein with fasting insulin, glucose, and glycosylated hemoglobin: The Third National Health and Nutrition Examination Survey, 1988–1994. Am J Epidemiol 2002; 155:65–71.

    Article  PubMed  Google Scholar 

  86. McLaughlin T, Abbasi F, Lamendola C, Liang L, Reaven G, Schaaf P, Reaven P. Differentiation between obesity and insulin resistance in the association with C-reactive protein. Circulation 2002; 106:2908–2912.

    Article  CAS  PubMed  Google Scholar 

  87. Bloomgarden ZT. Inflammation, atherosclerosis, and aspects of insulin action. Diabetes Care 2005; 28:2312–2319.

    Article  PubMed  Google Scholar 

  88. Bautista LE. Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence. J Hum Hypertens 2003; 17:223–230.

    Article  CAS  PubMed  Google Scholar 

  89. Grundy SM. Inflammation, hypertension, and the metabolic syndrome. JAMA 2003; 290:3000–3002.

    Article  CAS  PubMed  Google Scholar 

  90. Yamada S, Gotoh T, Nakashima Y, Kayaba K, Ishikawa S, Nago N, Nakamura Y, Hoh Y, Kajii E. Distribution of serum C-reactive protein and its association with atherosclerotic risk factors in a Japanese population: Jichi Medical School Cohort Study. Am J Epidemiol 2001; 153:1183–1190.

    Article  CAS  PubMed  Google Scholar 

  91. Chae CU, Lee RT, Rifai N, Ridker PM. Blood pressure and inflammation in apparently healthy men. Hypertension 2001; 38:399–403.

    CAS  PubMed  Google Scholar 

  92. Schillaci G, Pirro M, Gemelli F, Pasqualini L, Vaudo G, Marchesi S, Siepi D, Bagaglia F, Mannarino E. Increased C-reactive protein concentrations in never-treated hypertension: The role of systolic and pulse pressures. J Hypertens 2003; 21:1841–1846.

    Article  CAS  PubMed  Google Scholar 

  93. Lakoski SG, Cushman M, Palmas W, Blumenthal R, D’ Agostino RB, Jr., Herrington DM. The relationship between blood pressure and C-reactive protein in the Multi-Ethnic Study of Atherosclerosis (MESA). J Am Coll CardioI 2005; 46:1869–1874.

    Article  CAS  Google Scholar 

  94. Abramson JL, Weintraub WS, Vaccarino V. Association between pulse pressure and C-reactive protein among apparently healthy U.S. adults. Hypertension 2002; 39:197–202.

    Article  CAS  PubMed  Google Scholar 

  95. Amar J, Ruidavets JB, Sollier CB, Bongard V, Boccalon H, Chamontin B, Drouet L, Ferrieres J. Relationship between C reactive protein and pulse pressure is not mediated by atherosclerosis or aortic stiffness. J Hypertens 2004; 22:349–355.

    Article  CAS  PubMed  Google Scholar 

  96. Bautista LE, Atwood JE, O’Malley PG, Taylor AJ. Association between C-reactive protein and hypertension in healthy middle-aged men and women. Coron Artery Dis 2004; 15:331–336.

    Article  PubMed  Google Scholar 

  97. Bautista LE, Lopez-Jaramillo P, Vera LM, Casas JP, Otero AP, Guaracao AI. Is C-reactive protein an independent risk factor for essential hypertension? J Hypertens 2001; 19:857–861.

    Article  CAS  PubMed  Google Scholar 

  98. Chrysohoou C, Pitsavos C, Panagiotakos DB, Skoumas J, Stefanadis C. Association between prehypertension status and inflammatory markers related to atherosclerotic disease: The ATTICA Study. Am J Hypertens 2004; 17:568–573.

    Article  CAS  PubMed  Google Scholar 

  99. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: An 8-year follow-up of 14,719 initially healthy American women. Circulation 2003; 107:391–397.

    Article  PubMed  Google Scholar 

  100. Fernandez-Real JM, Vayreda M, Richart C, Gutierrez C, Broch M, Vendrell J, Ricart W. Circulating interleukin 6 levels, blood pressure, and insulin sensitivity in apparently healthy men and women. J Clin Endocrinol Metab 2001; 86:1154–1159.

    Article  CAS  PubMed  Google Scholar 

  101. Bautista LE, Vera LM, Arenas lA, Gamarra G. Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-alpha) and essential hypertension. J Hum Hypertens 2005; 19:149–154.

    Article  CAS  PubMed  Google Scholar 

  102. Chappell DC, Varner SE, Nerem RM, Medford RM, Alexander RW. Oscillatory shear stress stimulates adhesion molecule expression in cultured human endothelium. Circ Res 1998; 82:532–539.

    CAS  PubMed  Google Scholar 

  103. Ryan SM, Waack BJ, Weno BL, Heistad DD. Increases in pulse pressure impair acetylcholineinduced vascular relaxation. Am J Physiol 1995; 268:H359–363.

    CAS  PubMed  Google Scholar 

  104. Davey Smith G, Lawlor DA, Harbord R, Timpson N, Rumley A, Lowe GD, Day IN, Ebrahim S. Association of C-reactive protein with blood pressure and hypertension: Life course confounding and mendelian randomization tests of causality. Arterioscler Thromb Vasc Biol 2005; 25:1051–1056.

    Article  PubMed  CAS  Google Scholar 

  105. Kannel WB. Elevated systolic blood pressure as a cardiovascluar risk factor. Am J Cardiol 2000; 85:251–255.

    Article  CAS  PubMed  Google Scholar 

  106. Franklin SS, Khan SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful in predicting risk for coronary heart Disease? The Framingham Heart Study. Circulation 1999; 100:354–360.

    CAS  PubMed  Google Scholar 

  107. Benetos A, Rudnichi A, Safar M, Guize L. Pulse pressure and cardiovascular mortality in normotensive and hypertensive subjects. Hypertension 1998; 32:560–564.

    CAS  PubMed  Google Scholar 

  108. Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of developing hypertension. JAMA 2003; 290:2945–2951.

    Article  CAS  PubMed  Google Scholar 

  109. Amar J, Ruidavets JB, Peyrieux JC, Mallion JM, Ferrieres J, Safar ME, Chamontin B. C-reactive protein elevation predicts pulse pressure reduction in hypertensive subjects. Hypertension 2005; 46: 151–155.

    Article  CAS  PubMed  Google Scholar 

  110. Bouloumie A, Bauersachs J, Linz W, Scholkens BA, Wiemer G, Fleming I, Busse R. Endothelial dysfunction coincides with an enhanced nitric oxide synthase expression and superoxide anion production. Hypertension 1997; 30:934–941.

    CAS  PubMed  Google Scholar 

  111. Srikumar N, Brown NJ, Hopkins PN, Jeunemaitre X, Hunt SC, Vaughan DE, Williams GH. PAI-1 in human hypertension: Relation to hypertensive groups. Am J Hypertens 2002; 15:683–690.

    Article  CAS  PubMed  Google Scholar 

  112. Poli KA, Tofler GH, Larson MG, Evans JC, Sutherland PA, Lipinska I, Mittleman MA, Muller JE, D’ Agostino RB, Wilson PW, Levy D. Association of blood pressure with fibrinolytic potential in the Framingham offspring population. Circulation 2002; 101:264–269.

    Google Scholar 

  113. Capers QT, Alexander RW, Lou P, De Leon H, Wilcox IN, Ishizaka N, Howard AB, Taylor WR. Monocyte chemoattractant protein-1 expression in aortic tissues of hypertensive rats. Hypertension 1997; 30:1397–1402.

    CAS  PubMed  Google Scholar 

  114. Crawford DW, Blankenhorn DH. Arterial wall oxygenation, oxyradicals, and atherosclerosis. Atherosclerosis 1991; 89:97–108.

    Article  CAS  PubMed  Google Scholar 

  115. Feingold KR, Grunfeld C. Role of cytokines in inducing hyperlipidemia. Diabetes 1992; 4(suppl 2):97–101.

    Google Scholar 

  116. Hotamisligil GS, Peraldi P, Budavari A, Ellis R, White MF, Spiegelman BM. IRS-I-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-alpha-and obesity-induced insulin resistance. Science 1996; 271:665–668.

    Article  CAS  PubMed  Google Scholar 

  117. Pickup JC, Mattock MB, Chusney GD, Burt D. NIDDM as a disease of the innate immune system: Association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia 1997; 40: 1286–1292.

    Article  CAS  PubMed  Google Scholar 

  118. Saito I, Folsom AR, Brancati FL, Duncan BB, Chambless LE, McGovern PG. Nontraditional risk factors for coronary heart disease incidence among persons with diabetes: The Atherosclerosis Risk in Communities (ARIC) Study. Ann Intern Med 2000; 133:81–91.

    CAS  PubMed  Google Scholar 

  119. Rutter MK, Meigs JB, Sullivan LM, D’ Agostino RB, Sr., Wilson PW. C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation 2004; 110:380–385.

    Article  CAS  PubMed  Google Scholar 

  120. Florez H, Castillo-Florez S, Mendez A, Casanova-Romero P, Larreal-Urdaneta C, Lee D, Goldberg R. C-reactive protein is elevated in obese patients with the metabolic syndrome. Diabetes Res Clin Pract 2006; 71:92–100.

    Article  CAS  PubMed  Google Scholar 

  121. LaMonte MJ, Ainsworth BE, Durstine JL. Influence of cardiorespiratory fitness on the association between C-reactive protein and metabolic syndrome prevalence in racially diverse women. J Womens Health (Larchmt) 2005; 14:233–239.

    Article  Google Scholar 

  122. Frohlich M, Imhof A, Berg G, Hutchinson WL, Pepys MB, Boeing H, Muche R, Brenner H, Koenig W. Association between C-reactive protein and features of the metabolic syndrome: A populationbased study. Diabetes Care 2000; 23:1835–1839.

    Article  CAS  PubMed  Google Scholar 

  123. Malik S, Wong ND, Franklin S, Pio J, Fairchild C, Chen R. Cardiovascular disease in U.S. patients with metabolic syndrome, diabetes, and elevated C-reactive protein. Diabetes Care 2005; 28:690–693.

    Article  CAS  PubMed  Google Scholar 

  124. Sattar N, Gaw A, Scherbakova O, Ford I, O’Reilly DS, Haffner SM, Isles C, Macfarlane PW, Packard CJ, Cobbe SM, Shepherd J. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003; 108:414–419.

    Article  CAS  PubMed  Google Scholar 

  125. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Jr., Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome: An American Heart AssociationlNational Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112:2735–2752.

    Article  PubMed  Google Scholar 

  126. Kahn R, Buse J, Ferrannini E, Stem M. The metabolic syndrome: time for a critical appraisal: Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2005; 28:2289–2304.

    Article  PubMed  Google Scholar 

  127. Bakker SJ, Gansevoort RT, Stuveling EM, Gans RO, de Zeeuw D. Microalbuminuria and C-reactive protein: Similar messengers of cardiovascular risk? Curr Hypertens Rep 2005; 7:379–384.

    Article  CAS  PubMed  Google Scholar 

  128. Lipid, lipoproteins, C-reactive protein, and hemostatic factors at baseline in the diabetes prevention program. Diabetes Care 2005; 28:2472–2479.

    Google Scholar 

  129. Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15:539–553.

    Article  CAS  PubMed  Google Scholar 

  130. Balkau B, Charles MA. Comment on the provisional report from the WHO consultation: European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999; 16:442–443.

    Article  CAS  PubMed  Google Scholar 

  131. Einhorn D, Reaven GM, Cobin RH, Ford E, Ganda OP, Handelsman Y, Hellman R, Jellinger PS, Kendall D, Krauss RM, Neufeld ND, Petak SM, Rodbard HW, Seibel JA, Smith DA, Wilson PW. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract 2003; 9:237–252.

    PubMed  Google Scholar 

  132. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome: A new worldwide definition. Lancet 2005; 366:1059–1062.

    Article  PubMed  Google Scholar 

  133. Schillaci G, Pirro M, Vaudo G, Gemelli F, Marchesi S, Porcellati C, Mannarino E. Prognostic value of the metabolic syndrome in essential hypertension. J Am Coli Cardiol 2004; 43:1817–1822.

    Article  Google Scholar 

  134. Angelico F, Del Ben M, Conti R, Francioso S, Feole K, Fiorello S, Cavallo MG, Zalunardo B, Lirussi F, Alessandri C, Violi F. Insulin resistance, the metabolic syndrome, and nonalcoholic fatty liver disease. J Clin Endocrinol Metab 2005; 90:1578–1582.

    Article  CAS  PubMed  Google Scholar 

  135. Hamaguchi M, Kojima T, Takeda N, Nakagawa T, Taniguchi H, Fujii K, Omatsu T, Nakajima T, Sarui H, Shimazaki M, Kato T, Okuda J, Ida K. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 2005; 143:722–728.

    CAS  PubMed  Google Scholar 

  136. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, McCullough AJ, Natale S, Forlani G, Melchionda N. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome. Diabetes 2001; 50:1844–1850.

    Article  CAS  PubMed  Google Scholar 

  137. Marchesini G, Marzocchi R, Agostini F, Bugianesi E. Nonalcoholic fatty liver disease and the metabolic syndrome. Curr Opin Lipidol 2005; 16:421–427.

    Article  CAS  PubMed  Google Scholar 

  138. Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91:48–53.

    Article  CAS  PubMed  Google Scholar 

  139. Rabelo Acevedo M, Vick MR. Association between the polycystic ovary syndrome and the metabolic syndrome in Puerto Rico. P R Health Sci J 2005; 24:203–206.

    PubMed  Google Scholar 

  140. Vrbikova J, Vondra K, Cibula D, Dvorakova K, Stanicka S, Sramkova D, Sindelka G, Hill M, Bendlova B, Skrha J. Metabolic syndrome in young Czech women with polycystic ovary syndrome. Hum Reprod 2005; 20:3328–3332.

    Article  CAS  PubMed  Google Scholar 

  141. Bugianesi E. Review article: Steatosis, the metabolic syndrome and cancer. Aliment Pharmacol Ther 2005; 22(suppl 2):40–43.

    Article  PubMed  Google Scholar 

  142. Vgontzas AN, Bixler EO, Chrousos GP. Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev 2005; 9:211–224.

    Article  PubMed  Google Scholar 

  143. Svatikova A, Wolk R, Gami AS, Pohanka M, Somers VK. Interactions between obstructive sleep apnea and the metabolic syndrome. Curr Diab Rep 2005; 5:53–58.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Channing Laboratory, Brigham and Women’s Hospital, Boston, MA

    Yiqing Song MD, SeD

  2. Harvard Medical School and School of Public Health, Boston, MA

    Simin Liu MD, MPH, MS, SeD (Professor of Medicine and Epidemiology)

  3. Brigham and Women’s Hospital, Boston, MA

    Joann E. Manson MD, Dr.PH (Professor and Chief of Preventive Medicine)

Authors
  1. Yiqing Song MD, SeD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simin Liu MD, MPH, MS, SeD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joann E. Manson MD, Dr.PH
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Obesity, Diabetes, and Aging Research Center, University of South Florida College of Medicine, Tampa, FL

    Barbara Caleen Hansen PhD (Professor of Internal Medicine and Pediatrics Director) (Professor of Internal Medicine and Pediatrics Director)

  2. Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA

    George A. Bray MD (Boyd Professor) (Boyd Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Song, Y., Liu, S., Manson, J.E. (2008). High-Sensitivity C-Reactive Protein and the Metabolic Syndrome. In: Hansen, B.C., Bray, G.A. (eds) The Metabolic Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-60327-116-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-116-5_9

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-738-9

  • Online ISBN: 978-1-60327-116-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation