Association of C-Reactive Protein with Surrogate Measures of Insulin Resistance among Nondiabetic US Adults: Findings from National Health and Nutrition Examination Survey 1999–2002

Abstract

Background: Increased C-reactive protein (CRP) concentration and insulin resistance (IR) are associated with increased rates of adverse cardiovascular events. We sought to examine the relationship of CRP with surrogate measures of IR among nondiabetic adults in the US. Insulin resistance (IR) 5 is a pathophysiological state characterized by a subnormal physiological response to insulin concentrations within reference intervals. Experimental and epidemiological studies have demonstrated a strong association of IR with many diseases or metabolic abnormalities, including coronary heart disease, stroke, type 2 diabetes, hypertension, dyslipidemia, systemic inflammation, and atherogenesis (1, 2 ).It is estimated that approximately 20.6 million adults aged 20 years or older in the US have diabetes, with the majority of these having type 2 diabetes in 2005 (3 ). The prevalence of hyperinsulinemia has increased by 35% among nondiabetic adults in the US in the past decade (4 ). It is believed that IR and subsequently compensatory hyperinsulinemia develop much earlier than ␤-cell dysfunction and may exist and progress years before even prediabetes would be diagnosed by the detection of

Evaluation of Lasting High Levels of CRP among the Patients with Metabolic Syndrome

“…The levels of CRP in the subjects of MetS were relatively higher than those of the lean controls as reported elsewhere. In most of the MetS subjects, the levels of CRP were less than 10 mg/L [9,19]. Eight out of MetS subjects, however, exhibited high levels of CRP (more than 20 mg/L).…”

“…In MetS patients, insulin resistance and liver steatosis reportedly cause the elevation of CRP level [5,19,25].…”

C-Reactive Protein Is Elevated 30 Years After Eclamptic Pregnancy

“…15,16 Although the causal pathways are uncertain, insulin resistance and dyslipidemia could represent adverse consequences of proinflammatory cytokines on insulin signaling and lipid metabolizing pathways. 29 We chose CRP over other inflammatory markers partly because of the relatively high within-person consistency of CRP levels over time (despite the fact that CRP can increase acutely due to ischemic stress or infection) 13 and because of its stability in frozen serum samples.…”

“…12,13 Evidence also implicates CRP, and thus inflammation, as a useful clinical measure for identifying risk of developing the insulin resistance syndrome, particularly in women. 14,15 Serum CRP concentrations correlate positively with abdominal obesity, hyperinsulinemia, and other components of the insulin resistance syndrome. Nevertheless, associations of CRP with insulin resistance independent of obesity suggest that divergent pathways linking inflammation and insulin resistance are of importance, especially among nonobese individuals.…”

“…Nevertheless, associations of CRP with insulin resistance independent of obesity suggest that divergent pathways linking inflammation and insulin resistance are of importance, especially among nonobese individuals. 15,16 Further, prospective studies have shown that individuals meeting criteria for the insulin resistance syndrome who have elevated CRP concentrations (greater than 3 mg/L) are at higher risk for cardiovascular events than individuals with the insulin resistance syndrome who do not have elevated CRP. 17,18 We previously examined Icelandic postmenopausal women who experienced eclampsia during their reproductive years.…”