Article Text

  1. E. S. Miguelino,
  2. S. Devaraj,
  3. I. Jialal
  1. Laboratory for Atherosclerosis and Metabolic Research, University of California, Davis Medical Center, Sacramento, CA


Metabolic syndrome (MS) is a common disorder, comprising a constellation of risk factors including abdominal obesity, dyslipidemia, hypertension, and impaired fasting glucose levels and is associated with increased cardiovascular mortality. Inflammation plays a crucial role in atherosclerosis. Several prospective studies have demonstrated that high levels of C-reactive protein (CRP) predict cardiovascular events. CRP levels are elevated in subjects with MS. Abdominal obesity is a predominant feature of MS. The adipose tissue secretes an anti-inflammatory adipocytokine, adiponectin, which is decreased in subjects with MS. Thus, the aim of the study was to determine if the CRP:adiponectin ratio will provide a better discriminant for MS than CRP alone. Age-matched subjects without MS (controls) and > 3 features (MS-by NCEP criteria), were recruited (n = 68/group). Following informed consent, fasting blood was drawn. CRP levels were measured by automated immunoassay and adiponectin was measured by ELISA, both assays with inter- and intraassay CVs of < 7%. CRP levels were significantly elevated in subjects with MS [median and interquartile range MS: 3.9 mg/L (2.9, 5.7); C: 1.3 mg/(0.6, 2.8), p < .001] while adiponectin levels were significantly lower in MS subjects [median and interquartile range MS: 7.8 (5.6, 9.5); C: 8.2 mg/L (7.3, 9.1), p < .05]. Furthermore, there was a significant increase in CRP:adiponectin ratio in MS [median and interquartile range MS: 0.56 (0.29, 0.87); C:0.17 (0.08, 0.39); p < .001]. The CRP:adiponectin ratio was significantly better in predicting MS (89%, p < .02) than either CRP alone (67%) or adiponectin alone (31%). Furthermore, the CRP:adiponectin ratio correlated better with multiple features of MS (waist, low HDL, glucose, blood pressure, etc) than CRP alone (r = .81 for ratio and r = .66 for CRP, p < .01). Thus, the CRP:adiponectin ratio may provide a better objective measure for diagnosis of MS and monitoring therapeutic manipulations in the clinical setting.

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