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Background-The National Cholesterol Education Program (NCEP) recently proposed a simple definition for metabolic syndrome. Information on the prospective association of this definition for coronary heart disease (CHD) and type 2 diabetes is currently limited. Methods and Results-We used a modified NCEP definition with body mass index in place of waist circumference.Baseline assessments in the West of Scotland Coronary Prevention Study were available for 6447 men to predict CHD risk and for 5974 men to predict incident diabetes over 4.9 years of follow-up. Mean LDL cholesterol was similar but C-reactive protein was higher (PϽ0.0001) in the 26% of men with the syndrome compared with those without.

on behalf of the WOSCOPS Executive CommitteeBackground-Leptin plays a role in fat metabolism and correlates with insulin resistance and other markers of the metabolic syndrome, independent of total adiposity. Therefore, we hypothesized that raised leptin levels may identify men at increased risk of a coronary event in the West of Scotland Coronary Prevention Study (WOSCOPS). Methods and Results-Plasma leptin levels were measured at baseline in 377 men (cases) who subsequently experienced a coronary event and in 783 men (controls) who remained free of an event during the 5-year follow-up period of the study. Controls were matched to cases on the basis of age and smoking history and were representative of the entire WOSCOPS cohort. Leptin levels were significantly higher in cases than controls (5.

Accumulating evidence implicates inflammation as a potential pathway in the pathogenesis of type 2 diabetes. The objective of the present study was to assess the ability of C-reactive protein (CRP) to predict the development of diabetes in middle-aged men in the West of Scotland Coronary Prevention Study. Baseline plasma samples for CRP measurement were available for 5,245 men of whom 127 were classified as having a transition from normal glucose control to overt diabetes during the study, based on American Diabetes Association criteria. Baseline CRP was an important predictor of the development of diabetes in univariate analysis (hazard ratio [HR] for an increase of 1 SD ‫؍‬ 1.55; 95% CI 1.32-1.82; P < 0.0001). In multivariate analysis, CRP remained a predictor of diabetes development (HR 1.30; 95% CI 1.07-1.58; P ‫؍‬ 0.0075) independent of other clinically employed predictors, including baseline BMI and fasting triglyceride and glucose concentrations. Moreover, there was a graded increase in risk across CRP quintiles throughout the study, evident at even 1 year of follow-up. The highest quintile (CRP >4.18 mg/l) was associated with a greater than threefold risk of developing diabetes (HR 3.07; 95% CI 1.33-7.10) in a multivariate analysis at 5 years. Thus, CRP predicts the development of type 2 diabetes in middle-aged men independently of established risk factors. Because CRP, the most commonly used acute-phase protein in clinical practice, is very stable in serum, our observations have clinical potential in helping to better predict individuals destined to develop type 2 diabetes. They also add to the notion that low-grade inflammation is important in the pathogenesis of type 2 diabetes. Diabetes 51: 1596 -1600, 2002 C -reactive protein (CRP) is the prototypical, and most commonly used, acute-phase reactant marker of inflammation in the body. Increases in CRP concentration (even when within the clinically normal range) and of other inflammatory markers are independently predictive of future cardiovascular events (1,2). Cross-sectional studies have shown that elevated CRP levels correlate significantly with features of the metabolic (insulin resistance) syndrome, including indexes of adiposity, hyperinsulinemia and insulin sensitivity index, hypertriglyceridemia, and low HDL cholesterol (3-5).Recently, data from the Women's Health Study identified elevated levels of CRP as a predictor of the development of diabetes in women (6), independent of BMI and insulin, although other established predictors such as fasting lipids and blood pressure were not considered. This finding is consistent with other studies (7,8) showing that other markers of inflammation (white cell count [WCC], serum albumin, and serum amyloid A) predict the development of diabetes.The objective of the present study was to assess the ability of baseline serum CRP concentration to predict the development of type 2 diabetes in men, in conjunction with other established predictors such as plasma triglyceride, during the 5-year follow-up period of t...