Association between insulin resistance and c-reactive protein among Peruvian adults

Abstract

ObjectiveInsulin resistance (IR), a reduced physiological response of peripheral tissues to the action of insulin, is one of the major causes of type 2 diabetes. We sought to evaluate the relationship between serum C-reactive protein (CRP), a marker of systemic inflammation, and prevalence of IR among Peruvian adults.MethodsThis population based study of 1,525 individuals (569 men and 956 women; mean age 39 years old) was conducted among residents in Lima and Callao, Peru. Fasting plasma glucose, insulin, and CRP concentrations were measured using standard approaches. Insulin resistance was assessed using the homeostasis model (HOMA-IR). Categories of CRP were defined by the following tertiles: <0.81 mg/l, 0.81-2.53 mg/l, and >2.53 mg/l. Logistic regression procedures were employed to estimate odds ratios (OR) and 95% confidence intervals (CI).ResultsElevated CRP were significantly associated with increased mean fasting insulin and mean HOMA-IR concentrations (p < 0.001). Women with CRP concentration >2.53 mg/l (upper tertile) had a 2.18-fold increased risk of IR (OR = 2.18 95% CI 1.51-3.16) as compared with those in the lowest tertile (<0.81 mg/l). Among men, those in the upper tertile had a 2.54-fold increased risk of IR (OR = 2.54 95% CI 1.54-4.20) as compared with those in the lowest tertile.ConclusionOur observations among Peruvians suggest that chronic systemic inflammation, as evidenced by elevated CRP, may be of etiologic importance in insulin resistance and diabetes.

Co-effect of insulin resistance and biomarkers of inflammation and endothelial dysfunction on hypertension

“…6,22 Moreover, experimental and epidemiological data have indicated that the inflammatory process is associated with impaired insulin sensitivity and the development of dysglycemic conditions. 30 A study conducted in Peru among 1525 individuals 31 found that elevated CRP were significantly and positively associated with increased mean fasting insulin concentrations and mean HOMA-IR (Po0.001) in both women and men. Women with CRP concentrations 42.53 mg l À1 (upper tertile) had a 2.18-fold increased risk of IR (OR¼2.18; 95% CI 1.51-3.16) compared with those in the lowest tertile (o0.81 mg l À1 ).…”

Análise da relação de qualidade da dieta com nível de atividade física e destes com perfil lipídico e estado inflamatório em indivíduos de risco cardiometabólico

“…A PCR, proteína de fase aguda indicativa de inflamação sistêmica, tem sido considerada potente marcador de eventos cardiovasculares (RIDKER et al 2001; RIDKER e SILVERTON, 2007 (RIDKER et al, 1997, RIDKER e SILVERTON, 2007GELAYE et al, 2010).…”

“…RIDKER et al (1997) observaram risco três vezes maior de infarto do miocárdio em indivíduos sem histórico de DCV no quartil mais elevado de PCR quando comparados ao menor quartil. Também foram detectadas associações da PCR com glicemia, insulinemia e HOMA-IR, sugerindo que o metabolismo da glicose é afetado pela inflamação (RIDKER et al, 1997, RIDKER e SILVERTON, 2007GELAYE et al, 2010).…”

“…O último desfecho pode estar relacionado à sua ação deletéria no sistema de coagulação, favorecendo a adesão de células ao endotélio, elevação do fibrinogênio e atividade plaquetária. Tais ações denotam seu papel relevante na patogênese da SM e DCV (FAIN 2006; FANTUZZI e MAZZONE, 2007).A PCR, proteína de fase aguda indicativa de inflamação sistêmica, tem sido considerada potente marcador de eventos cardiovasculares (RIDKER et al 2001; RIDKER e SILVERTON, 2007 (RIDKER et al, 1997, RIDKER e SILVERTON, 2007GELAYE et al, 2010).Entre as adipocitocinas com ação endócrina destaca-se a adiponectina que apresenta importante papel na sensibilidade à insulina e proteção cardiovascular. Em contraste com outras, encontra-se diminuída na obesidade, DM2, dislipidemia e DCV (HARA et al, 2005;TAKEMURA et al, 2007;AHIMA LAZAR, 2008; DEEPA e DONG, 2008).…”

Common variants in the CRP gene are associated with serum C-reactive protein levels and body mass index in healthy individuals in Mexico

“…Elevated blood levels of CRP have been associated with atherosclerosis (Momiyama et al, 2010), unstable angina (Rizzello et al, 2007), diabetes (Shankar and Li, 2008), metabolic syndrome (Lai et al, 2010), insulin resistance (Gelaye et al, 2010), and obesity (Wee et al, 2008). Prospective studies have shown that increased blood CRP levels are associated with a greater risk of ischemic heart and cerebrovascular diseases (Sabatine et al, 2007;Oudi et al, 2010).…”