Festa A, D'Agostino R, Howard G, Mykkänen L, Tracy R P, Haffner S M
Department of Medicine, University of Texas Health Science Center at San Antonio, 78228-3900, USA.
Circulation. 2000 Jul 4;102(1):42-7. doi: 10.1161/01.cir.102.1.42.
Inflammation has been suggested as a risk factor for the development of atherosclerosis. Recently, some components of the insulin resistance syndrome (IRS) have been related to inflammatory markers. We hypothesized that insulin insensitivity, as directly measured, may be associated with inflammation in nondiabetic subjects.
We studied the relation of C-reactive protein (CRP), fibrinogen, and white cell count to components of IRS in the nondiabetic population of the Insulin Resistance Atherosclerosis Study (IRAS) (n=1008; age, 40 to 69 years; 33% with impaired glucose tolerance), a multicenter, population-based study. None of the subjects had clinical coronary artery disease. Insulin sensitivity (S(I)) was measured by a frequently sampled intravenous glucose tolerance test, and CRP was measured by a highly sensitive competitive immunoassay. All 3 inflammatory markers were correlated with several components of the IRS. Strong associations were found between CRP and measures of body fat (body mass index, waist circumference), S(I), and fasting insulin and proinsulin (all correlation coefficients >0.3, P<0.0001). The associations were consistent among the 3 ethnic groups of the IRAS. There was a linear increase in CRP levels with an increase in the number of metabolic disorders. Body mass index, systolic blood pressure, and S(I) were related to CRP levels in a multivariate linear regression model.
We suggest that chronic subclinical inflammation is part of IRS. CRP, a predictor of cardiovascular events in previous reports, was independently related to S(I). These findings suggest potential benefits of anti-inflammatory or insulin-sensitizing treatment strategies in healthy individuals with features of IRS.
炎症已被认为是动脉粥样硬化发生的一个危险因素。最近，胰岛素抵抗综合征（IRS）的一些成分与炎症标志物有关。我们推测，直接测量的胰岛素不敏感性可能与非糖尿病受试者的炎症有关。
我们在胰岛素抵抗动脉粥样硬化研究（IRAS）的非糖尿病人群（n = 1008；年龄40至69岁；33%有糖耐量受损）中研究了C反应蛋白（CRP）、纤维蛋白原和白细胞计数与IRS成分的关系，这是一项多中心、基于人群的研究。所有受试者均无临床冠心病。通过频繁采样的静脉葡萄糖耐量试验测量胰岛素敏感性（S(I)），通过高灵敏度竞争性免疫测定法测量CRP。所有这三种炎症标志物均与IRS的几个成分相关。发现CRP与体脂测量值（体重指数、腰围）、S(I)、空腹胰岛素和胰岛素原之间存在强关联（所有相关系数>0.3，P<0.0001）。这些关联在IRAS的三个种族群体中是一致的。随着代谢紊乱数量的增加，CRP水平呈线性升高。在多变量线性回归模型中，体重指数、收缩压和S(I)与CRP水平相关。
我们认为慢性亚临床炎症是IRS的一部分。CRP在先前的报告中是心血管事件的预测指标，与S(I)独立相关。这些发现表明，对于具有IRS特征的健康个体，抗炎或胰岛素增敏治疗策略可能有益。
