González A Soto, Guerrero D Bellido, Soto M Buño, Díaz S Pértega, Martinez-Olmos M, Vidal O
Endocrinology and Nutrition Service, Juan Canalejo Hospital, La Coruña, Spain.
Eur J Clin Nutr. 2006 Jun;60(6):802-9. doi: 10.1038/sj.ejcn.1602384. Epub 2006 Feb 22.
Patients with metabolic syndrome (MS) have above-average risk of developing atherosclerosis and cardiovascular disease. Inflammation plays a key role in the development of atherosclerosis. High levels of the acute phase reactants C-reactive protein (CRP) and ferritin have been reported to correlate with various components of MS.
The serum CRP, ferritin, glucose, insulin, triglycerides, HDL-cholesterol and total cholesterol concentrations of 598 obese or overweight patients were determined, together with relevant anthropometric parameters. Insulin resistance was evaluated by the HOMA method. MS was diagnosed using the ATP III criteria.
CRP levels were higher among patients with central obesity than in those without (5.8 vs 3.9 mg/l; P=0.003), and higher among those with fasting plasma glucose concentrations >or=110 mg/dl than in those with lower concentrations (7.4 vs 4.1 mg/l; P=0.01). Serum ferritin levels were higher among patients with triglyceride concentrations >or=150 mg/dl than in those with lower levels (76.8 vs 40.1 ng/ml; P<0.001), and higher among those with fasting plasma glucose concentrations >or=110 mg/dl than in those with lower concentrations (75.7 vs 41.7 ng/ml; P=0.005). The number of MS criteria that were satisfied increased with CRP and ferritin levels. Patients with insulin resistance also had higher CRP and ferritin levels than those without, 7.3 vs 4.3 mg/l for CRP (P=0.032) and 124.5 vs 80.1 ng/ml for ferritin (P<0.001).
MS and insulin resistance are associated with elevated serum CRP and ferritin. Evaluation of subclinical chronic inflammation in patients with MS and/or insulin resistance by determination of these markers might aid in their evaluation as candidates for aggressive intervention against cardiovascular risk factors.
代谢综合征（MS）患者发生动脉粥样硬化和心血管疾病的风险高于平均水平。炎症在动脉粥样硬化的发展中起关键作用。据报道，急性期反应物C反应蛋白（CRP）和铁蛋白水平升高与MS的各种组分相关。
测定了598例肥胖或超重患者的血清CRP、铁蛋白、葡萄糖、胰岛素、甘油三酯、高密度脂蛋白胆固醇和总胆固醇浓度，以及相关人体测量参数。采用HOMA法评估胰岛素抵抗。使用ATP III标准诊断MS。
中心性肥胖患者的CRP水平高于非中心性肥胖患者（5.8 vs 3.9 mg/l；P = 0.003），空腹血糖浓度≥110 mg/dl的患者高于血糖浓度较低的患者（7.4 vs 4.1 mg/l；P = 0.01）。甘油三酯浓度≥150 mg/dl的患者血清铁蛋白水平高于甘油三酯水平较低的患者（76.8 vs 40.1 ng/ml；P < 0.001），空腹血糖浓度≥110 mg/dl的患者高于血糖浓度较低的患者（75.7 vs 41.7 ng/ml；P = 0.005）。满足MS标准的数量随CRP和铁蛋白水平增加。胰岛素抵抗患者的CRP和铁蛋白水平也高于无胰岛素抵抗患者，CRP分别为7.3 vs 4.3 mg/l（P = 0.032），铁蛋白分别为124.5 vs 80.1 ng/ml（P < 0.001）。
MS和胰岛素抵抗与血清CRP和铁蛋白升高有关。通过测定这些标志物评估MS和/或胰岛素抵抗患者的亚临床慢性炎症，可能有助于将他们评估为积极干预心血管危险因素的候选对象。
