Metabolic Syndrome, C-Reactive Protein, and Mortality in U.S. Blacks and Whites: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Abstract

OBJECTIVEWe evaluate associations of metabolic syndrome (MetS), C-reactive protein (CRP), and a CRP-incorporated definition of MetS (CRPMetS) with risk of all-cause mortality in a biracial population.RESEARCH DESIGN AND METHODSWe studied 23,998 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, an observational study of black and white adults ≥45 years old across the U.S. Elevated CRP was defined as ≥3 mg/L and MetS by the revised Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III; ATP III) criteria (three of five components). CRPMetS was defined as presence of three out of six components, with elevated CRP added to ATP III criteria as a sixth component. Cox models were used to calculate hazard ratios (HRs) for all-cause mortality, and population attributable risk (PAR) was calculated. Stratified analyses based on race and diabetes status were performed.RESULTSThere were 9,741 participants (41%) with MetS and 12,179 (51%) with CRPMetS at baseline. Over 4.8 years of follow-up, 2,050 participants died. After adjustment for multiple confounders, MetS, elevated CRP, and CRPMetS were each significantly associated with increased mortality risk (HRs 1.26 [95% CI 1.15–1.38], 1.55 [1.41–1.70], and 1.34 [1.22–1.48], respectively). The PAR was 9.5% for MetS, 18.1% for CRP, and 14.7% for CRPMetS. Associations of elevated CRP and of CRPMetS with mortality were significantly greater in whites than blacks, while no differences in associations were observed based on diabetes status.CONCLUSIONSBy definition, CRPMetS identifies more people at risk than MetS but still maintains a similar mortality risk. Incorporating CRP into the definition for MetS may be useful in identifying additional high-risk populations to target for prevention.

Associations of 25-hydroxyvitamin D with markers of inflammation, insulin resistance and obesity in black and white community-dwelling adults

“…IL-10 was measured using the Milliplex MAP Human Cardiovascular Disease (CVD) Panel 3 (Millipore Corporation; Billerica, MA) run as a single-plex assay with an inter-assay CV range of 8.3–12.1%. High sensitivity C-reactive protein (hsCRP) was measured by particle enhanced immunonephelometry using the BNII nephelometer (N High Sensitivity CRP; Dade Behring, Deerfield, IL) with inter-assay CVs of 2.1–5.7% [11]. Serum glucose and insulin were measured using the Ortho Vitros 950 IRC Clinical Analyzer (Johnson & Johnson Clinical Diagnostics, Raritan, NJ) and Roche Elecsys 2010 System (Roche Diagnostics, Indianapolis, IN), respectively.…”

Rutaecarpine ameliorates hyperlipidemia and hyperglycemia in fat-fed, streptozotocin-treated rats via regulating the IRS-1/PI3K/Akt and AMPK/ACC2 signaling pathways

“…Rutaecarpine treatment in Fat-fed/STZ rats significantly inhibited NF-κB p65 ( Figure 7E), a key protein in the NF-κB cascade. Moreover, as CRP ( Figure 7A), MCP-1 ( Figure 7B), TNF-α ( Figure 7C), and IL-6 ( Figure 7D) are considered important members of inflammatory pathways [64][65][66] , their inhibition suggests that inflammatory pathways are involved in the underlying mechanism by which rutaecarpine regulates lipid and carbohydrate homeostasis. Rutaecarpine restored pancreatic islet areas impaired by HFD and STZ ( Figure 8H and 8L).…”

Meal preparation and cleanup time and cardiometabolic risk over 14years in the Study of Women's Health Across the Nation (SWAN)

“…This sample is advantageous because women can experience adverse changes in their cardiometabolic profile during the menopausal transition (Matthews et al, 2009; Sowers et al, 2007; Woodard et al, 2011), and because women have primary responsibility for meal preparation in up to three-fourths of U.S. households (Flagg et al, 2013; Harnack et al, 1998). Analyses tested the hypothesis that baseline levels and longitudinal changes in meal preparation/cleanup time are inversely associated with the probability of meeting criteria for metabolic syndrome, a cluster of five co-occuring cardiometabolic risk factors (abdominal obesity, hypertension, hypertriglyceridemia, prediabetes, and low high-density lipoprotein (HDL) cholesterol; (Alberti et al, 2009; National Cholesterol Education Program Expert Panel on Detection and Adults, 2002) that affects one-quarter to one-third of adults (Beltran-Sanchez et al, 2013; Mozumdar and Liguori, 2011) and is associated with cardiovascular disease, type 2 diabetes mellitus, and all-cause mortality (Ford et al, 2008; Malik et al, 2004; Suzuki et al, 2014). …”