Combination of C-reactive Protein and High Molecular Weight (HMW)-Adiponectin Reflects Further Metabolic Abnormalities Compared with Each of Them Alone in Japanese Type 2 Diabetic Subjects

Abstract

Abstract. Objective: Serum C-reactive protein (CRP) and adiponectin levels predict atherosclerosis and coronary heart disease. However, the efficacy of the combination of both markers remains unknown. In the present study, we investigated whether the combination of CRP and adiponectin is associated with further metabolic abnormalities compared to each of them alone. Research design and methods: Eighty-three Japanese type 2 diabetic outpatients participated in this study. We measured serum high-sensitive CRP and high molecular weight (HMW)-adiponectin, and investigated their relationship with various metabolic parameters. Results: In univariate analysis, CRP was significantly correlated with diastolic blood pressure and HDL-cholesterol. On the other hand, HMW-adiponectin was significantly correlated with systolic (SBP) and diastolic blood pressure, plasma glucose, HDL-cholesterol, triglycerides and HOMA-IR, but not with CRP. We then classified the subjects into three groups: low CRP and high HMW-adiponectin levels (low risk group, 19%), high CRP and low HMW-adiponectin levels (high risk group, 22%), and others. In Spearman rank correlation coefficient analysis, this classification was significantly associated with a larger number of metabolic risk factors: SBP, glucose, HbA1c, LDL-cholesterol, HDL-cholesterol, triglycerides and HOMA-IR, compared with classification by CRP or HMW-adiponectin alone. Conclusion: These results suggest that combination of CRP and HMW-adiponectin reflects further metabolic abnormalities compared with each of them in type 2 diabetic subjects. The combined measurement of both markers may be useful to detect cardiovascular high risk patients.Key words: C-reactive protein, Adiponectin, Coronary risk factor, Type 2 diabetes mellitus (Endocrine Journal 55: 331-338, 2008) BOTH type 2 diabetes and atherosclerosis are characterized by low-grade inflammation and insulin resistance [1,2]. Patients with type 2 diabetes show a 2-to 5-fold increase in coronary heart disease (CHD)-related death [3], thus it is very important to precisely evaluate the risk of CHD in diabetic patients in clinical settings. Serum CRP and adiponectin reflect low-grade inflammation and insulin resistance, respectively, and are known as the important markers of atherosclerosis and CHD [4,5]. Serum CRP level is increased in obese [6] and diabetic [7-9] subjects, and predicts the onset of cardiovascular disease [4,[10][11][12]. On the other hand, serum adiponectin level is negatively associated with visceral fat [13] and insulin resistance [13][14][15]. It has been reported that adiponectin level is decreased in obese [16] and diabetic subjects [17] and subjects with cardiovas-

Role of plasma adiponectin /C-reactive protein ratio in obesity and type 2 diabetes among African Americans

“…Adiponectin and CRP are independent risk factors of CVD, together serve a synergistic role in metabolic regulation in the general population and T2D subjects [35][36][37] . We found that AA women with high adiponectin and low CRP levels, which translated into a high ratio, had significantly lower FG, IN, HOMA-IR, WC, %BF and BMI relative to those with a low ratio.…”

Usefulness of C-Reactive Protein to High-Molecular-Weight Adiponectin Ratio to Predict Insulin Resistance and Metabolic Syndrome in Japanese Men

“…Recently, Tabara et al have shown synergistic effects of CRP and HMW adiponectin on metabolic abnormalities in older Japanese subjects 24) , which indicate the superiority of a combination of both markers. We have also reported the synergistic effects of both markers on metabolic abnormalities in Japanese type 2 diabetic subjects 25) ; however, these studies did not measure waist circumference to evaluate MetS. In contrast, Devaraj et al have reported a comparison among CRP, HMW adiponectin and its ratio in the evaluation of MetS in 123 subjects with MetS and 91 subjects without MetS 26) .…”

“…Establishing a robust biomarker that can predict MetS instead of examining individual features will be important to screen populations of individuals, monitor the natural history of the disease, and measure the response to therapeutic interventions. We and others have shown a synergistic effect of CRP and HMW adiponectin to evaluate MetS in the general population 24) and type 2 diabetic subjects 25) , suggesting a superior effect when both markers are combined. In contrast, Devaraj et al have reported that CRP, HMW adiponectin and its ratio were comparable to predict MetS 26) .…”

“…Plasma glucose and serum lipids were assayed by routine automated laboratory methods as described previously 13,25,27,28) . Serum insulin concentration was measured by an enzyme immunoassay, using a commercially available kit (Tosoh, Tokyo, Japan), with intra-and interassay coefficients of 2.9 to 4.6% and 4.5 to 7.0%, respectively.…”

“…HMW adiponectin was measured using a commercially available kit (HMW adiponectin ELISA Kit; Fujirebio, Tokyo, Japan) as previously reported 13,25,27,28) . This ELISA system does not need a denaturing step, and the monoclonal antibody (IH7) is reported to react specifically with the HMW form of adiponectin 29) .…”