Santos A-C, Lopes C, Guimarães J T, Barros H
Department of Hygiene and Epidemiology, University of Porto Medical School, Alameda Professor Hernani Monteiro, Porto, Portugal.
Int J Obes (Lond). 2005 Dec;29(12):1452-6. doi: 10.1038/sj.ijo.0803035.
Traditional cardiovascular risk factors such as central obesity, high blood pressure and insulin resistance, all constituents of metabolic syndrome, have been associated with increased levels of C-reactive protein (CRP). Therefore, this marker of low-grade inflammation may play a major role in the pathogenesis of cardiovascular diseases. In this study, data from a representative sample of urban adults was used to evaluate the association between CRP and metabolic syndrome, accounting for the type and number of its constituents.
Using random digit dialing, 1022 participants, aged 18-92 y, were selected. All participants completed a structured questionnaire comprising of information on social, demographic, behavioral and clinical aspects. Anthropometrics and blood pressure were recorded and a fasting blood sample collected. Metabolic syndrome was defined, according to the Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, as the presence of three or more of the following characteristics: waist circumference greater than 102 cm in men and 88 cm in women; triglyceride levels > or = 150 mg/dl; high-density lipoprotein cholesterol levels < 40 mg/dl in men and < 50 mg/dl in women; blood pressure > or = 130/85 mm Hg; and serum glucose > or = 110 mg/dl. High-sensitivity CRP was assessed by immunonephelometric assay. After excluding 65 participants with CRP > or = 10 mg/l, 957 subjects (599 women and 358 men) remained for analysis. Geometric means were compared after adjustment for age, sex, alcohol consumption and smoking.
Higher mean levels of CRP (2.34 vs 1.36, P < 0.001) were observed when metabolic syndrome was present. Also, mean CRP levels were significantly higher in the presence of central obesity (2.45 vs 1.24, P < 0.001), high blood pressure (1.76 vs 1.12, P < 0.001), hypertriglyceridemia (2.17 vs 1.32, P < 0.001) and high fasting glucose (1.96 vs 1.46, P = 0.032). We found a significant increasing trend (P < 0.001) in mean levels of CRP as the number of features of metabolic syndrome increased. The major contributing features for high CRP levels were central obesity and high blood pressure.
Present data show that increasing severity of metabolic syndrome is associated with increasing CRP. Additionally, we found that central obesity and high blood pressure are the most important determinants of the low-grade chronic inflammation present in metabolic syndrome.
传统心血管危险因素，如中心性肥胖、高血压和胰岛素抵抗，均为代谢综合征的组成部分，它们都与C反应蛋白（CRP）水平升高有关。因此，这种低度炎症标志物可能在心血管疾病的发病机制中起主要作用。在本研究中，我们使用来自城市成年人代表性样本的数据来评估CRP与代谢综合征之间的关联，并考虑了其组成部分的类型和数量。
通过随机数字拨号，选取了1022名年龄在18 - 92岁的参与者。所有参与者都完成了一份结构化问卷，内容包括社会、人口统计学、行为和临床方面的信息。记录了人体测量数据和血压，并采集了空腹血样。根据《成人高胆固醇血症检测、评估和治疗专家委员会第三次报告》，代谢综合征的定义为存在以下三种或更多特征：男性腰围大于102厘米，女性腰围大于88厘米；甘油三酯水平≥150毫克/分升；男性高密度脂蛋白胆固醇水平<40毫克/分升，女性<50毫克/分升；血压≥130/85毫米汞柱；血清葡萄糖≥110毫克/分升。通过免疫比浊法评估高敏CRP。在排除65名CRP≥10毫克/升的参与者后，剩余957名受试者（599名女性和358名男性）进行分析。在对年龄、性别、饮酒和吸烟进行调整后，比较了几何均值。
存在代谢综合征时，观察到CRP的平均水平更高（2.34对1.36，P<0.001）。此外，在存在中心性肥胖（2.45对1.24，P<0.001）、高血压（1.76对1.12，P<0.001）、高甘油三酯血症（2.17对1.32，P<0.001）和空腹血糖升高（1.96对1.46，P = 0.032）时，CRP的平均水平也显著更高。我们发现，随着代谢综合征特征数量的增加，CRP的平均水平呈显著上升趋势（P<0.001）。导致CRP水平升高的主要因素是中心性肥胖和高血压。
目前的数据表明，代谢综合征严重程度的增加与CRP升高有关。此外，我们发现中心性肥胖和高血压是代谢综合征中存在的低度慢性炎症的最重要决定因素。
