Relationship between the Serum Concentrations of C-reactive Protein and Parameters of Adiposity and Insulin Resistance in Patients with Type 2 Diabetes Mellitus

Abstract

Abstract. Serum C-reactive protein (CRP) concentrations have been reported to be associated with body fat, especially visceral fat accumulation, but most studies up to now have been conducted on non-diabetic subjects. In this study, we investigated the association between the serum CRP concentrations and parameters of adiposity and insulin resistance in both Japanese type 2 diabetes patients and non-diabetic subjects. A total of 248 Japanese subjects (140 type 2 diabetes patients and 108 non-diabetic subjects) were enrolled for the study. The degree of insulin resistance was estimated by the homeostasis model assessment (HOMA-R) method. Fat accumulation was evaluated by measuring visceral and subcutaneous fat areas at the level of the umbilicus in abdominal CT scans. To assess hepatic fat content, the ratio of CT attenuation value of the liver to that of the spleen (L/S ratio) was calculated. Serum CRP was found to be significantly correlated with various indices of adiposity, including L/S ratio, visceral fat area (VFA), subcutaneous fat area (SFA), and HOMA-R, in both the diabetic patients and the non-diabetic subjects. After adjustment for five variables (age, gender, serum CRP, HbA1c, and smoking), serum CRP was still significantly correlated with L/S ratio, VFA, SFA, and HOMA-R in the diabetic patients. We also found that changes in serum CRP concentrations were correlated with changes in the VFA and SFA at 1 year after the baseline in 24 diabetic patients. We conclude that serum CRP may be closely related to the degree of liver steatosis and visceral fat accumulation in Japanese type 2 diabetes mellitus patients.

Serum Butyrylcholinesterase is Strongly Associated with Adiposity, the Serum Lipid Profile and Insulin Resistance

“…We were able to further show that even after adjustment for age, gender and HbA1c, the serum BChE activity was still correlated significantly with the HDL-C, TG and LDL-C (Table 3), confirming the previously reported association between the serum BChE activity and the lipid profile and hepatic fat content (6,7,9). We also examined whether the changes in the serum BChE activity were associated with changes in the L/S ratio, VFA and SFA at 1 year after the initial hospitalization in the patients ( We had previously demonstrated an association of the serum ferritin and serum CRP concentrations with the parameters of adiposity and degree of insulin resistance (16,17) …”

“…We had previously shown an association between the serum ferritin and serum CRP concentrations and parameters of adiposity (16,17). Therefore, we carried out multiple regression analysis to quantify the impact of the measured…”

“…On the other hand, the relationship of radiologically measured abdominal fat accumulation and hepatic fat content to metabolic risk factors for atherosclerosis has been intensively investigated, and both the visceral fat area (VFA) and hepatic fat content are now recognized to be correlated with the plasma TG level and glucose utilization (11)(12)(13)(14)(15). In fact, we have recently demonstrated an association between the serum ferritin and serum C reactive protein (CRP) concentrations and parameters of adiposity, including VFA, and the degree of insulin resistance (16,17 …”

Significant Association of Serum Albumin with Severity of Retinopathy and Neuropathy, in Addition to That of Nephropathy, in Japanese Type 2 Diabetic Patients

“…Thus, it is possible that chronic inflammation is also responsible for the decrease in the serum levels of albumin in diabetic patients [6]. Elevation of the serum levels of the acute-phase inflammatory marker, CRP, has been reported to be related to insulin resistance [7,8], suggesting the role of chronic low-grade inflammation in the development of insulin resistance. We performed multiple and logistic regression analysis with adjustment for three variables (age, gender and serum CRP), and the results revealed that the serum albumin was still significantly associated with the severity of proliferative retinopathy and proteinuria, the absence of Achilles tendon reflexes, as well as the MNCV, MMFWL and TMFWL (Tables 3, 4).…”

Fat redistribution preferentially reflects the anti-inflammatory benefits of pioglitazone treatment

“…They suggested that the sex differences of CRP and apolipoprotein B in diabetic patients were associated with differences in abdominal adiposity. Indeed, the relationship between CRP and abdominal adiposity has been reported in several studies [21][22][23][24][25][26]. A recent study from the Framingham Offspring Study used volumetric multidetector computed tomography (CT) to show that both subcutaneous adipose tissue and visceral adipose tissue are associated with plasma inflammatory markers including CRP and that the association for visceral adipose tissue by CRP is stronger than that for subcutaneous adipose tissue [23].…”