Adipocyte Fatty Acid Binding Protein and C-Reactive Protein Levels as Indicators of Insulin Resistance Development

Abstract

Background. Adipocyte fatty acid-binding protein (aFABP) has recently been identified as a potential circulating marker for metabolic syndrome. C-reactive protein (CRP), a sensitive marker of inflammation, is increased in individuals with diabetes and metabolic syndrome due to the development of subclinical inflammation. The study uses logistic regression models to analyze the relations between aFABP and CRP along with other parameters of insulin resistance. The objective was to investigate the potential use of aFABP and CRP levels as tools in the diagnosis of the metabolic syndrome.Methods and results. The following groups were studied: healthy individuals (A, n=122), obese ind1ividuals (B, n=213) and patients diagnosed with metabolic syndrome (C, n=79). Obese persons in Group B had parameters suggestive of early insulin resistance: hypertension, hyperglycaemia, QUICKI (0.305) and higher aFABP levels as compared with the healthy subjects. Group C individuals were diagnosed with metabolic syndrome, as evidenced by the QUICKI markers for insulin resistance (0.293), high aFABP levels (35.3 mg/l). CRP concentrations were lowest in Group A healthy individuals (0.67 mg/l), higher in Group B obese subjects (2.65 mg/l) and highest in Group C patients with metabolic syndrome (3.62 mg/l). Logistic regression models showed an association of aFABP and CRP with BMI (OR 1.12 and 1.39, compared Group A vs C). An association of aFABP and CRP with the QUICKI index showed OR 1.48 and 1.37 (Group A vs C); with triglyceride levels showed OR 1.68 and 1.52 (Group A vs C). An association of aFABP and CRP with glycaemia showed OR 1.48 and 1.51 (Group A vs C), with insulinaemia showed OR 1.44 and 1.38 (Group A vs C) respectively.Conclusions. AFABP levels were higher in obese individuals and highest in those with metabolic syndrome. CRP concentrations were increased in obese persons whereas individuals with metabolic syndrome were found to have high-risk CRP levels. Logistic regression models showed an association of aFABP and CRP with BMI as well as an association of aFABP and CRP with parameters of insulin resistance, namely the QUICKI index, triglyceride levels, glycaemia and insulinaemia. Both methods are of diagnostic benefit for predicting metabolic syndrome, especially in previously untreated patients.

Biomarkers of insulin sensitivity and insulin resistance: Past, present and future

“…In addition, A-FABP might have proinflammatory properties related to lipopolysaccharide-induced inflammation by forming a positive feedback loop with the JNK/c-Jun signaling cascade 53 , which is involved in impaired insulin action. Several studies showed correlation between A-FABP and proinflammatory factors, like C-reactive protein (CRP), and their similar importance in predicting insulin resistance 54,55 .…”

Significance of C-reactive protein determination in patients with metabolic syndrome

“…Istraživanje je pokazalo da su osobe sa razvijenim MS imale znatno veće vrednosti koncentracije CRP i da su kod njih znatno učestalije merene koncentracije CRP veće od 5 mg/L u odnosu na osobe koje nisu razvile MS, što ukazuje na postojanje hronične, sistemske, zapaljenjske reakcije niskog intenziteta kod njih, i ovaj nalaz je u saglasnosti s nalazima drugih studija (3,7,(9)(10)(11)(12). Izmerene prosečne koncentracije CRP od 2,46 mg/L kod ispitanika kontrolne grupe i 5,33 mg/L kod ispitanika sa MS jasno pokazuju proinflamatornu reakciju i uticaj MS i njegovih karakteristika na porast koncentracije CRP, najviše kao posledicu gojaznosti i značajno većih vrednosti antropometrijskih parametara, obima struka i BMI.…”