High-sensitivity C-reactive protein and the hypertriglyceridemic waist in patients with type 2 diabetes and metabolic syndrome

Background: High-sensitivity C-reactive protein is an important biomarker of systemic inflammation. We studied the contribution to cardiovascular risk of increased high-sensitivity C-reactive protein in patients with type 2 diabetes with or without concomitant metabolic syndrome.
Material and Method: The series included 381 patients (199 men, 182 women; median age, 66 years; age range, 50-80 years) with a mean duration of type 2 diabetes of 9+/-8 years. Standard physical examinations and laboratory investigations were administered to all patients. Modified National Cholesterol Education Program III criteria for defining the metabolic syndrome were used. High-sensitivity C-reactive protein was estimated by immunoturbidimetry and other laboratory tests using standard methods.
Results: High-sensitivity C-reactive protein correlated (Spearman's correlation) significantly positively with body mass index and waist size, fasting plasma triglyceride levels, apolipoprotein-B, gamma glutamyl transferase, homeostasis model assessment of insulin resistance, and fibrinogen, and negatively with high-density lipoprotein cholesterol. However, only waist, fibrinogen, apolipoprotein-B, plasma glucose, and gamma glutamyl transferase levels appeared to be associated with high-sensitivity C-reactive protein on multiple logistic regression model analyses. In those diabetic patients with concomitant metabolic syndrome, the hypertriglyceridemic waist appeared to be a major factor for an increased high-sensitivity C-reactive protein concentration.
Conclusions: The hypertriglyceridemic waist contributes to the metabolic syndrome and most likely is an important factor increasing high-sensitivity C-reactive protein levels and consequently, relative coronary risk in patients with type 2 diabetes of any sex and age.

Keywords: Metabolic Syndrome X - physiopathology, Hypertriglyceridemia - physiopathology, Diabetes Mellitus, Type 2 - physiopathology, Waist-Hip Ratio, Statistics, Nonparametric, C-Reactive Protein - analysis, Aged, 80 and over, Age Distribution